既往关于饮酒与脂肪肝关系的研究得出的结果并不一致。近期发表在《Alimentary pharmacology & therapeutics》的一项研究旨在探讨日均饮酒量和酗酒与脂肪肝的关系，并分析日均饮酒量和酗酒与身体质量指数（BMI）联合对脂肪肝的综合影响。文献阅读：Aliment Pharmacol Ther 2015 Jan 15

研究方法

使用一项来自德国东北部波美拉尼亚健康研究（SHIP）的基于人口学的研究数据，该研究包括4009名成人。通过自我报告评估酒精消耗量，血清糖缺失转铁蛋白（CDT）分析作为酒精消耗的生物标志物。通过超声诊断肝脂肪变性。

Figure 1 | Combined effect of average alcohol consumption and body mass index on the likelihood of men having hepatic steatosis. Adjusted logistic regression odds ratios of men having hepatic steatosis. Analyses are adjusted for age and HbA1c.*** P < 0.0001, ** P < 0.001,* P < 0.05 compared to current abstainers and normal weight individuals.

Figure 2 | Combined effect of average alcohol consumption and body mass index on the likelihood of women having hepatic steatosis. Adjusted logistic regression odds ratios of women having hepatic steatosis. Analyses are adjusted for age, HbA1c and menopausal status. * P < 0.05 compared to current abstainers and normal weight individuals.

研究结果

分析显示，初始每天消耗20g酒精的男性中，日均酒精消耗量与肝脏脂肪变性呈剂量反应关系[与戒酒者相比，校正的比值比（OR）1.53；95％置信区间（CI）1.15-2.05]。使用CDT作为替代变量证实了这些结果。男性酗酒与脂肪肝有关（与非酗酒者相比，酗酒者校正的OR是1.36，95％CI 1.06-1.74）。在日均饮酒量增加合并超重或肥胖的男性和女性中，出现肝脏脂肪变性的可能性增加。同样，酗酒合并超重或者肥胖增加肝脏脂肪变性的可能性。

Figure 3 | Combined effect of binge drinking and body mass index on the likelihood of men having hepatic steatosis. Adjusted logistic regression odds ratios of men having hepatic steatosis. Analyses are adjusted for age, HbA1c and average daily alcohol consumption. *** P < 0.0001 compared to nonbinge drinking and normal weight individuals.

Figure 4 | Combined effect of binge drinking and body mass index on the likelihood of women having hepatic steatosis. Adjusted logistic regression odds ratios of women having hepatic steatosis. Analyses are adjusted for age, HbA1c, average daily alcohol consumption and menopausal status. *** P < 0.0001 compared to nonbinge drinking and normal weight individuals.

结论

在现有的研究人群中，超重和肥胖大大增加高水平日均饮酒量和酗酒对肝脂肪变性的影响。这一发现强调有必要筛查多种危险因素以预防肝脂肪变性。