Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jul 21.
doi: 10.1111/apt.70286. Online ahead of print.

Persistent Binge Drinking History Associated With Advanced Liver Fibrosis and All-Cause Mortality in MetALD

Zhe-Kun Xiong  1 , Ru-Tao Lin  2 , Bi-Wei Chen  1 , Xin Xin  2   3 , Tao-Ying Deng  1 , Qin-Mei Sun  2 , Yi-Yang Hu  2   4 , Li-Ming Gan  1 , Qin Feng  2   3   5
Affiliations

Persistent Binge Drinking History Associated With Advanced Liver Fibrosis and All-Cause Mortality in MetALD

Zhe-Kun Xiong et al. Aliment Pharmacol Ther. .

Abstract

Background: Metabolic dysfunction and alcohol-related liver disease (MetALD) is characterised by the coexistence of metabolic dysfunction and moderate alcohol intake. In this population, the impact of specific drinking patterns and history, particularly persistent binge drinking (PBD) history, on disease severity and prognosis remains unclear.

Aim: To evaluate the association between a history of PBD and the risks of advanced fibrosis and all-cause mortality in individuals with MetALD.

Methods: We analysed data from NHANES 1999-2016, including adults with MetALD. PBD is defined as having had a history of drinking ≥ 4 (women) or 5 (men) alcoholic beverages almost every day, based on ALQ150/151 questionnaires. Advanced fibrosis was defined as FIB-4 > 2.67, and mortality outcomes were obtained from the National Death Index. Multivariable logistic and Cox regression models were used to examine the associations between PBD and both liver fibrosis and all-cause mortality, adjusting for alcohol intake and other confounders.

Results: Among 865 individuals with MetALD, 326 (37.7%) reported a history of PBD. Compared to those without PBD, participants with PBD had a higher risk of advanced fibrosis (adjusted OR = 2.23, 95% CI: 1.12-4.45, p = 0.023). PBD was also associated with increased all-cause mortality (adjusted HR = 1.48, 95% CI: 1.03-2.13, p = 0.035). A higher risk of overnight hospitalisation in PBD supports these findings (adjusted OR = 1.88, 95% CI: 1.15-3.06, p = 0.012).

Conclusion: PBD history is associated with increased risks of advanced fibrosis and mortality in MetALD. Clinical assessment should include an evaluation of drinking patterns and history, particularly persistent binge drinking.

Keywords: MetALD; binge drinking; fibrosis; mortality.

PubMed Disclaimer

References

    1. M. E. Rinella, J. V. Lazarus, V. Ratziu, et al., “A Multisociety Delphi Consensus Statement on New Fatty Liver Disease Nomenclature,” Journal of Hepatology 79, no. 6 (2023): 1542–1556.
    1. J. P. Arab, L. A. Díaz, J. Rehm, et al., “Metabolic Dysfunction and Alcohol‐Related Liver Disease (MetALD): Position Statement by an Expert Panel on Alcohol‐Related Liver Disease,” Journal of Hepatology 82, no. 4 (2025): 744–756.
    1. EASL EAFT, EASD EAFT, and EASO EAFT, “EASL‐EASD‐EASO Clinical Practice Guidelines on the Management of Metabolic Dysfunction‐Associated Steatotic Liver Disease (MASLD),” Journal of Hepatology 81, no. 3 (2024): 492–542.
    1. M. Kalligeros, A. Vassilopoulos, S. Vassilopoulos, D. W. Victor, E. Mylonakis, and M. Noureddin, “Prevalence of Steatotic Liver Disease (MASLD, MetALD, and ALD) in the United States: NHANES 2017‐2020,” Clinical Gastroenterology and Hepatology 22, no. 6 (2024): 1330–1332.e4.
    1. H. Leal‐Lassalle, O. Estévez‐Vázquez, F. J. Cubero, and Y. A. Nevzorova, “Metabolic and Alcohol‐Associated Liver Disease (MetALD): A Representation of Duality,” Npj Gut and Liver 2, no. 1 (2025): 1.

LinkOut - more resources