Interpretation of metabolic dysfunction and alcohol-related liver disease： Position statement by an expert panel on alcohol-related liver disease （2024 edition）

Zhenyao JIANG; Binbin ZHANG; Jie LI; Junping SHI

doi:10.12449/JCH250308

Volume 41 Issue 3

Mar. 2025

Turn off MathJax

Article Contents

Abstract

References

Article Navigation > Journal of Clinical Hepatology > 2025 > 41(3): 442-445

PDF( 575 KB)

Interpretation of metabolic dysfunction and alcohol-related liver disease： Position statement by an expert panel on alcohol-related liver disease （2024 edition）

DOI: 10.12449/JCH250308

Zhenyao JIANG¹,
Binbin ZHANG^{1, 2},
Jie LI^{3
,
,
,},
Junping SHI^{1, 2
,
,
,}

1.
Clinical Medical College of Hangzhou Normal University，Hangzhou 310015，China
2.
Department of Infection and Hepatology，The Affiliated Hospital of Hangzhou Normal University，Hangzhou 310015，China
3.
Department of Infectious Disease，Nanjing Drum Tower Hospital，Affiliated Hospital of Medical School，Nanjing University，Nanjing 210008，China

Research funding:

National Science and Technology Major Project (2023ZD05508704)

More Information

Corresponding author: LI Jie， lijier@nju.edu.cn （ORCID： 0000-0003-0973-8645）; SHI Junping， 20131004@hznu.edu.cn （ORCID： 0000-0001-9434-897X）
Received Date: 2025-02-20
Accepted Date: 2025-03-18
Published Date: 2025-03-25

Abstract

Abstract

In November 2024， the Expert Group on Alcohol-related Liver Disease released a position statement on metabolic dysfunction and alcohol-related liver disease （MetALD）. MetALD is a new subtype of steatotic liver disease and refers to MASLD patients with a relatively large amount of alcohol consumption. The position statement points out the importance of accurate evaluation of alcohol consumption and recommends to quantify alcohol consumption using standard methods and alcohol biomarkers， and a comprehensive diagnosis should be made based on metabolic risk factors. In addition， the position statement analyzes the influence of drinking pattern on the diagnosis of MetALD and recommends to consider long-term drinking history during typing. The position statement also discusses the complex association between drinking and the diseases including metabolic syndrome， hepatic steatosis， fibrosis， and type 2 diabetes mellitus， and it is pointed out that the hierarchical management of patients should be optimized based on liver histological models and noninvasive models. The position statement elaborates on the definition of MetALD， drinking assessment， the interaction between alcohol use and metabolic dysfunction， and the methods for comprehensive management of MetALD， in order to facilitate learning and provide guidance for clinicians and researchers in clinical practice.
- Metabolic Dysfunction and Alcohol-Related Liver Disease,
- Diagnosis,
- Therapeutics,
- Consensus

FullText(HTML)

References(25)

References

[1]	RINELLA ME, LAZARUS JV, RATZIU V, et al. A multisociety Delphi consensus statement on new fatty liver disease nomenclature[J]. Ann Hepatol, 2024, 29( 1): 101133. DOI: 10.1016/j.aohep.2023.101133.
[2]	ARAB JP, LA DÍAZ, REHM J, et al. Metabolic dysfunction and alcohol-related liver disease(MetALD): Position statement by an expert panel on alcohol-related liver disease[J]. J Hepatol, 2024. DOI: 10.1016/j.jhep.2024.11.028.[ Online ahead of print]
[3]	What’s a standard drink measurment?[EB/OL].[ 2025-02-19]. https://rethinkingdrinking.‍niaaa.‍nih.‍gov/how-much-too-much/whats-standard-drink. https://rethinkingdrinking.‍niaaa.‍nih.‍gov/how-much-too-much/whats-standard-drink
[4]	PARADIS C, BUTT P, SHIELD K, et al. Canada’s guidance on alcohol and health[EB/OL].[ 2025-02-19]. https://www.ccsa.ca/canadas-guidance-alcohol-and-health. https://www.ccsa.ca/canadas-guidance-alcohol-and-health
[5]	SKINNER HA, SHEU WJ. Reliability of alcohol use indices. The lifetime drinking history and the MAST[J]. J Stud Alcohol, 1982, 43( 11): 1157- 1170. DOI: 10.15288/jsa.1982.43.1157.
[6]	BUSH K, KIVLAHAN DR, MCDONELL MB, et al. The AUDIT alcohol consumption questions(AUDIT-C): An effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project(ACQUIP). Alcohol Use Disorders Identification Test[J]. Arch Intern Med, 1998, 158( 16): 1789- 1795. DOI: 10.1001/archinte.158.16.1789.
[7]	LOUVET A, BOURCIER V, ARCHAMBEAUD I, et al. Low alcohol consumption influences outcomes in individuals with alcohol-related compensated cirrhosis in a French multicenter cohort[J]. J Hepatol, 2023, 78( 3): 501- 512. DOI: 10.1016/j.jhep.2022.11.013.
[8]	JONES AW. Brief history of the alcohol biomarkers CDT, EtG, EtS, 5-HTOL, and PEth[J]. Drug Test Anal, 2024, 16( 6): 570- 587. DOI: 10.1002/dta.3584.
[9]	HARRIS JC, LEGGIO L, FAROKHNIA M. Blood biomarkers of alcohol use: A scoping review[J]. Curr Addict Rep, 2021, 8( 4): 500- 508. DOI: 10.1007/s40429-021-00402-7.
[10]	FAKHARI S, WASZKIEWICZ N. Old and new biomarkers of alcohol abuse: Narrative review[J]. J Clin Med, 2023, 12( 6): 2124. DOI: 10.3390/jcm12062124.
[11]	GREEN EW, BYERS IS, DEUTSCH-LINK S. Closing the care gap: Management of alcohol use disorder in patients with alcohol-associated liver disease[J]. Clin Ther, 2023, 45( 12): 1189- 1200. DOI: 10.1016/j.clinthera.2023.09.017.
[12]	World Health Organization. Global Status Report on Alcohol and Health 2018[R]. Geneva: World Health Organization, 2019.
[13]	KIM HS, XIAO XJ, BYUN J, et al. Synergistic associations of PNPLA3 I148M variant, alcohol intake, and obesity with risk of cirrhosis, hepatocellular carcinoma, and mortality[J]. JAMA Netw Open, 2022, 5( 10): e2234221. DOI: 10.1001/jamanetworkopen.2022.34221.
[14]	DING CY, NG FAT L, BRITTON A, et al. Binge-pattern alcohol consumption and genetic risk as determinants of alcohol-related liver disease[J]. Nat Commun, 2023, 14: 8041. DOI: 10.1038/s41467-023-43064-x.
[15]	LLAMOSAS-FALCÓN L, REHM J, BRIGHT S, et al. The relationship between alcohol consumption, BMI, and type 2 diabetes: A systematic review and dose-response meta-analysis[J]. Diabetes Care, 2023, 46( 11): 2076- 2083. DOI: 10.2337/dc23-1015.
[16]	PARKER R, AITHAL GP, BECKER U, et al. Natural history of histologically proven alcohol-related liver disease: A systematic review[J]. J Hepatol, 2019, 71( 3): 586- 593. DOI: 10.1016/j.jhep.2019.05.020.
[17]	HAGSTRÖM H, THIELE M, ROELSTRAETE B, et al. Mortality in biopsy-proven alcohol-related liver disease: A population-based nationwide cohort study of 3 453 patients[J]. Gut, 2021, 70( 1): 170- 179. DOI: 10.1136/gutjnl-2019-320446.
[18]	SIMON TG, ROELSTRAETE B, KHALILI H, et al. Mortality in biopsy-confirmed nonalcoholic fatty liver disease: Results from a nationwide cohort[J]. Gut, 2021, 70( 7): 1375- 1382. DOI: 10.1136/gutjnl-2020-322786.
[19]	TAYLOR RS, TAYLOR RJ, BAYLISS S, et al. Association between fibrosis stage and outcomes of patients with nonalcoholic fatty liver disease: A systematic review and meta-analysis[J]. Gastroenterology, 2020, 158( 6): 1611- 1625. e 12. DOI: 10.1053/j.gastro.2020.01.043.
[20]	European Association for the Study of the Liver. Reply to: Correspondence on“EASL Clinical Practice Guidelines on non-invasive tests for evaluation of liver disease severity and prognosis-2021 update”[J]. J Hepatol, 2022, 76( 1): 251- 252. DOI: 10.1016/j.jhep.2021.10.008.
[21]	STERLING RK, DUARTE-ROJO A, PATEL K, et al. AASLD Practice Guideline on imaging-based noninvasive liver disease assessment of hepatic fibrosis and steatosis[J]. Hepatology, 2025, 81( 2): 672- 724. DOI: 10.1097/HEP.0000000000000843.
[22]	LEE AK, BOBB JF, RICHARDS JE, et al. Integrating alcohol-related prevention and treatment into primary care: A cluster randomized implementation trial[J]. JAMA Intern Med, 2023, 183( 4): 319- 328. DOI: 10.1001/jamainternmed.2022.7083.
[23]	SIMPSON RF, HERMON C, LIU B, et al. Alcohol drinking patterns and liver cirrhosis risk: Analysis of the prospective UK Million Women Study[J]. Lancet Public Health, 2019, 4( 1): e41- e48. DOI: 10.1016/S2468-2667(18)30230-5.
[24]	BECKER U, DEIS A, SØRENSEN TI, et al. Prediction of risk of liver disease by alcohol intake, sex, and age: A prospective population study[J]. Hepatology, 1996, 23( 5): 1025- 1029. DOI: 10.1002/hep.510230513.
[25]	DESALEGN H, DIAZ LA, REHM J, et al. Impact of alcohol use on liver disease outcomes[J]. Clin Liver Dis(Hoboken), 2024, 23( 1): e0192. DOI: 10.1097/CLD.0000000000000192.

Relative Articles

[1]	Chinese Society of Gastroenterology， Chinese Medical Association. Chinese consensus on clinical diagnosis and therapy of liver cirrhosis[J]. Journal of Clinical Hepatology, 2023, 39(9): 2057-2073.
[2]	Kechun WANG, Mingda WANG, Tian YANG. Key points in AASLD Practice Guidance on Prevention， Diagnosis， and Treatment of Hepatocellular Carcinoma （2023）[J]. Journal of Clinical Hepatology, 2023, 39(9): 2081-2086. doi: 10.3969/j.issn.1001-5256.2023.09.008
[3]	Liver Oncology Branch, China Association for the Promotion of International Exchange in Healthcare, Immunology Branch. Chinese expert consensus on targeted immunotherapy combined with local therapy for advanced hepatocellular cancer[J]. Journal of Clinical Hepatology, 2023, 39(12): 2782-2792. doi: 10.3969/j.issn.1001-5256.2023.12.006
[4]	Radiology of Infection Sub-branch, Radiology Branch, Chinese Medical Association, Committee on Radiology of Infection, Radiology Branch, Chinese Medical Doctor Association, Radiology Committee on Infectious and Inflammatory Disease, Chinese Research Hospital Association, Radiology of Infection Branch, Working and Treating Committee of HIV/AIDS and STD Association, Radiology of Infectious Disease Management Sub-branch, Infectious Disease Management Branch, Hospital Management Association in China, Beijing Imaging Diagnosis and Treatment Technology Innovation Alliance. Consensus on imaging techniques and diagnostic criteria for hepatitis B virus related early hepatocellular carcinoma[J]. Journal of Clinical Hepatology, 2021, 37(4): 787-791. doi: 10.3969/j.issn.1001-5256.2021.04.013
[5]	Group of Stem Cell Engineering, Medical Engineering Society of Chinese Medical Association. Expert consensus on standardized treatment of decompensated liver cirrhosis with stem cell transplantation (2021)[J]. Journal of Clinical Hepatology, 2021, 37(7): 1540-1544. doi: 10.3969/j.issn.1001-5256.2021.07.012
[6]	Chinese Society of Liver Cancer, Chinese Anti-Cancer Association. Chinese expert consensus on multidisciplinary treatment of liver cancer[J]. Journal of Clinical Hepatology, 2021, 37(2): 278-285. doi: 10.3969/j.issn.1001-5256.2021.02.008
[7]	Jiaxin ZHOU, Wen ZHANG. Interpretation of Chinese expert consensus on the diagnosis and treatment of IgG4-related diseases[J]. Journal of Clinical Hepatology, 2021, 37(9): 2062-2065. doi: 10.3969/j.issn.1001-5256.2021.09.012
[8]	Chinese Society for Emergency Medicine, Beijing-Tianjin-Hebei Alliance of Emergency Treatment and First Aid, Emergency Medicine Branch, Beijing Medical Association, Emergency Physicians Branch, Beijing Medical Doctor Association, Emergency Treatment and First Aid Branch, China Health Culture Association. Expert consensus on emergency diagnosis and treatment of acute pancreatitis[J]. Journal of Clinical Hepatology, 2021, 37(5): 1034-1041. doi: 10.3969/j.issn.1001-5256.2021.05.012
[9]	Radiology of Infection Sub-branch, Radiology Branch, Chinese Medical Association, Committee on Radiology of Infectious, Radiology Branch, Chinese Medical Doctor Association. Expert consensus on the imaging diagnosis of hepatic echinococcosis[J]. Journal of Clinical Hepatology, 2021, 37(4): 792-797. doi: 10.3969/j.issn.1001-5256.2021.04.014
[10]	Chinese Journal of Hepatology, Liver Cancer Study Group, Chinese Society of Hepatology, Chinese Medical Association. Expert consensus on multidisciplinary diagnosis and treatment of precancerous lesions of hepatocellular carcinoma( 2020 edition)[J]. Journal of Clinical Hepatology, 2020, 36(3): 514-518. doi: 10.3969/j.issn.1001-5256.2020.03.007
[11]	Guo Peng, Bie Ping. Interpretation of expert consensus on application of choledochoscope in diagnosis and treatment of hepatolithiasis (2019 edition)[J]. Journal of Clinical Hepatology, 2020, 36(1): 57-58. doi: 10.3969/j.issn.1001-5256.2020.01.012
[12]	International Hepato-Pancreato-Biliary Association, China Branch, Hepatic Hemangioma Professional Committee. Multidisciplinary expert consensus on the diagnosis and treatment of hepatic hemangioma (2019 edition)[J]. Journal of Clinical Hepatology, 2019, 35(9): 1928-1932. doi: 10.3969/j.issn.1001-5256.2019.09.008
[13]	Chinese Society of Hepatology, Chinese Medical Association; Chinese Society of Gastroenterology, Chinese Medical Association; Chinese Society of Infectious Diseases, Chinese Medical Association. Consensus on the diagnosis and therapy of hepatic fibrosis(2019)[J]. Journal of Clinical Hepatology, 2019, 35(10): 2163-2172. doi: 10.3969/j.issn.1001-5256.2019.10.007
[14]	Chinese Society of EndocrinologyChinese Medical Association. Consensus for diagnosis and treatment of nonalcoholic fatty liver diseases and metabolic disorders (2nd Edition)[J]. Journal of Clinical Hepatology, 2018, 34(10): 2103-2108. doi: 10.3969/j.issn.1001-5256.2018.10.010
[15]	Cooperative Group for Hepatic and Gall Diseases, Chinese Society of Gastroenterology, Chinese Medical Association. Expert consensus on diagnosis and treatment of pyrrolidine alkaloids-related sinusoidal obstruction syndrome (2017, Nanjing)[J]. Journal of Clinical Hepatology, 2017, 33(9): 1627-1637. doi: 10.3969/j.issn.1001-5256.2017.09.003
[16]	Han Ying, Zhu JiangYi. An interpretation of recommendations for expert consensus on the diagnosis and treatment of primary sclerosing cholangitis(2015)[J]. Journal of Clinical Hepatology, 2016, 32(3): 420-422. doi: 10.3969/j.issn.1001-5256.2016.03.003
[17]	Chinese Society of Hepatology, Chinese Medical Association; Chinese Society of Gastroenterology, Chinese Medical Association; Chinese Society of Infectious Diseases, Chinese Medical Association. Consensus on the diagnosis and management of primary sclerosing cholangitis(2015)[J]. Journal of Clinical Hepatology, 2016, 32(1): 23-31. doi: 10.3969/j.issn.1001-5256.2016.01.003
[18]	Chinese Society of Hepatology, Chinese Medical Association; Chinese Society of Gastroenterology, Chinese Medical Association; Chinese Society of Infectious Diseases, Chinese Medical Association. Consensus on the diagnosis and management of autoimmune hepatitis(2015)[J]. Journal of Clinical Hepatology, 2016, 32(1): 9-22. doi: 10.3969/j.issn.1001-5256.2016.01.002
[19]	Chinese Society of Hepatology, Chinese Medical Association; Chinese Society of Gastroenterology, Chinese Medical Association; Chinese Society of Infectious Diseases, Chinese Medical Association. Consensus on the diagnosis and management of primary biliary cirrhosis (cholangitis)(2015)[J]. Journal of Clinical Hepatology, 2015, 31(12): 1980-1988. doi: 10.3969/j.issn.1001-5256.2015.12.004
[20]	Chinese Society of Hepatology, Chinese Medical Association; Chinese Society of Gastroenterology, Chinese Medical Association; Chinese Society of Infectious Diseases, Chinese Medical Association. Consensus on the diagnosis and treatment of cholestasis liver diseases（2015）[J]. Journal of Clinical Hepatology, 2015, 31(12): 1989-1999. doi: 10.3969/j.issn.1001-5256.2015.12.005

Supplements(0)

Cited By

Proportional views

Proportional views

通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

Get Citation

PDF

XML

Article Metrics

Article views (56) PDF downloads(13)

Interpretation of metabolic dysfunction and alcohol-related liver disease： Position statement by an expert panel on alcohol-related liver disease （2024 edition）

DOI: 10.12449/JCH250308

Abstract

References

Relative Articles

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

About Journal

Submission Guideline

Journal Online

Hepatobiliary College

Guidelines

Export File

Citation

Format

Content