Alcohol Consumption and Nonalcoholic Fatty Liver Disease: Effects on Chronic Kidney Disease

AbstractNonalcoholic fatty liver disease (NAFLD) is a multisystem disease which is regarded as a separate risk factor for chronic kidney disease (CKD).Moderate alcohol consumption has been shown to reduce all-cause mortality in patients with NAFLD. Participants of ten rounds of the continuous National Health and Nutrition Examination Survey (NHANES:1998-2018) were included in this study. Participants with an HSI score more than 36 were considered to have NAFLD, which was determined using the Hepatic Steatosis Index (HSI) model. Multivariate logistic regression models were used to evaluate the effects of moderate alcohol consumption on CKD in both male and female populations. Subgroup analysis was performed after classifying patients with NAFLD by using the Fibrosis-4 (FIB-4) index.There were 17040 participants that qualified to take part in the study.The logistic regression analysis model showed that moderate alcohol consumption was a protective factor for CKD in male NAFLD patients, with an unadjusted OR: 0.37 (0.22,0.65), and P <0.001. After further adjustment for diabetes mellitus, ALT, AST, AKP, BUN, UA, HSI, TC and HDL-c, the association persisted. However, the association was not significant in female patients with NAFLD. Among men with low-fiber-risk, moderate alcohol consumption remained a protective factor for CKD (OR = 0.32, 95% CI 0.12-0.84, P=0.02), but the association was not significant in the high-fiber-risk group. Interestingly, patients with NAFLD who were at high risk of fibrosis showed a significant trend in favor of consuming more than or equal to 1.4 drinks per day (OR = 0.34, 95% CI 0.13-0.87, P=0.03).In female patients, both moderate alcohol consumption and excessive alcohol consumption were not significantly associated with CKD in either the low-risk group or the high-risk group. Taken together, moderate alcohol consumption is associated with a lower prevalence of CKD in men with NAFLD.