Resumen
La enfermedad hepática relacionada con el alcohol (ALD) representa una de las principales causas de hepatopatía crónica en todo el mundo, y engloba una variedad de trastornos como resultado del consumo de alcohol que incluyen: esteatosis simple, esteatohepatitis relacionada con el alcohol, hepatitis alcohólica, fibrosis, cirrosis y carcinoma hepatocelular. Además, algunas personas con enfermedad establecida e ingesta abundante de alcohol pueden desarrollar hepatitis alcohólica, entidad que cursa con una elevada mortalidad. No existe un tratamiento específico para la ALD, su manejo se basa en el abordaje del trastorno por consumo de alcohol para conseguir la abstinencia, que es el mayor factor pronóstico junto con la presencia de fibrosis; Por tanto, las estrategias de educación, prevención y diagnóstico precoz son la clave para reducir la carga de ALD.
Palabras clave
Enfermedad hepática relacionada con el alcohol
Esteatohepatitis
Cirrosis
Alcohol
Abstract
Alcohol-related liver disease (ALD) is one of the leading causes of chronic liver disease worldwide. It encompasses a variety of disorders that result from alcohol consumption, including simple steatosis, alcohol-related hepatic steatosis, alcoholic hepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma. In addition, some individuals with established disease and high alcohol intake may develop alcoholic hepatitis, a disease with a high mortality rate. There is no specific treatment for ALD. Its management is based on addressing the alcohol use disorder to achieve abstinence, which is the major prognostic factor along with the presence of fibrosis. Therefore, education, prevention, and early diagnosis strategies are essential for reducing the burden of ALD.
Keywords
Alcohol-related liver disease
Hepatic steatosis
Cirrhosis
Alcohol
Identifíquese
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Bibliografía
[1]
D.Q. Huang, P. Mathurin, H. Cortez-Pinto, R. Loomba.
Global epidemiology of alcohol-associated cirrhosis and HCC: trends, projections and risk factors.
Nat Rev Gastroenterol Hepatol., (2023), 20 pp. 37-49
[2]
R. Bataller , J. Cabezas, R. Aller, M. Ventura-Cots, J. Abad, A. Albillos, et al.
Alcohol-related liver disease. Clinical practice guidelines. Consensus document sponsored by AEEH.
Gastroenterol Hepatol., (2019), 42 pp. 657-676
[3]
Global status report on alcohol and health 2018. Geneva: World Health Organization; 2018.
[4]
T.H. Karlsen, N. Sheron, S. Zelber-Sagi, P. Carrieri, G. Dusheiko, E. Bugianesi, et al.
The EASL–Lancet Liver Commission: protecting the next generation of Europeans against liver disease complications and premature mortality.
The Lancet., (2022), 399 pp. 61-116
[5]
D.Q. Huang, A.G. Singal, Y. Kono, D.J.H. Tan, H.B. El-Serag, R. Loomba.
Changing global epidemiology of liver cancer from 2010 to 2019: NASH is the fastest growing cause of liver cancer.
Cell Metab., (2022), 34
[6]
Observatorio Español de las Drogas las Adicciones. Delegación del Gobierno para el Plan Nacional sobre Drogas O. Monografía. Alcohol 2021: Consumo y consecuencias. Disponible en: https://cpage.mpr.gob.es/.
[7]
A. Odriozola, A. Santos-Laso, M. del Barrio, J. Cabezas, P. Iruzubieta, M.T. Arias-Loste, et al.
Fatty liver disease, metabolism and alcohol interplay: A comprehensive review.
Int J Mol Sci., (2023), 24 pp. 7791
[8]
García Cortés M. El consumo de alcohol y las enfermedades digestivas [Internet]. Disponible en: www.saludigestivo.es.
[9]
H.K. Seitz, M.G. Neuman.
The history of alcoholic liver disease: From an unrecognized disease to one of the most frequent diseases in hepatology.
J Clin Med., (2021), 10 pp. 1-20
[10]
A.W. Yan, B. Schnabl.
Bacterial translocation and changes in the intestinal microbiome associated with alcoholic liver disease.
World J Hepatol., (2012), 4 pp. 110-118
[11]
D.W. Crabb, G.Y. Im, G. Szabo, J.L. Mellinger, M.R. Lucey.
Diagnosis and treatment of alcohol-associated liver diseases: 2019 Practice guidance from the American Association for the study of liver diseases.
Hepatology., (2020), 71 pp. 306-333
[12]
F. Åberg, J. Helenius-Hietala, P. Puukka, A. Jula.
Binge drinking and the risk of liver events: A population-based cohort study.
Liver International., (2017), 37 pp. 1373-1381
[13]
U. Becker, A. Deis, T.I.A. Sørensen, M. Grønbæk, K. Borch-Johnsen, C.F. Müller, et al.
Prediction of risk of liver disease by alcohol intake, sex, and age: A prospective population study.
Hepatology., (1996), 23 pp. 1025-1029
[14]
R.E. Levy, A.M. Catana, B. Durbin-Johnson, C.H. Halsted, V. Medici.
Ethnic differences in presentation and severity of alcoholic liver disease.
Alcohol Clin Exp Res., (2015), 39 pp. 566-574
[15]
F. Stickel, C. Moreno, J. Hampe, M.Y. Morgan.
The genetics of alcohol dependence and alcohol-related liver disease.
J Hepatol, (2017), 66 pp. 195-211
[16]
H.K. Seitz, F. Stickel.
Molecular mechanisms of alcohol-mediated carcinogenesis.
Nat Rev Cancer., (2007), 7 pp. 599-612
[17]
S. Liangpunsakul, J.J. Beaudoin, V.H. Shah, P. Puri, A.J. Sanyal, P.S. Kamath, et al.
Interaction between the patatin-like phospholipase domain-containing protein 3 genotype and coffee drinking and the risk for acute alcoholic hepatitis.
Hepatol Commun., (2018), 2 pp. 29-34
[18]
M. Hernández-Tejero, A. Clemente-Sánchez, R. Bataller.
Spectrum, screening, and diagnosis of alcohol-related liver disease.
J Clin Exp Hepatol., (2023), 13 pp. 75-87
[19]
Diagnostic and statistical manual of DSM-5 TM.
[20]
Clin Liver Dis (Hoboken)., (2016), 8 pp. 59-63
[21]
Quantifying alcohol consumption: Self-report, transdermal assessment, and prediction of dependence symptoms.
Addictive Behaviors., (2015), 50 pp. 205-212
[22]
M. Thursz, A. Gual, C. Lackner, P. Mathurin, C. Moreno, L. Spahr, et al.
EASL Clinical Practice Guidelines: Management of alcohol-related liver disease.
J Hepatol., (2018), 69 pp. 154-181
[23]
D.N. Rasmussen, M. Thiele, S. Johansen, M. Kjærgaard, K.P. Lindvig, M. Israelsen, et al.
Prognostic performance of 7 biomarkers compared to liver biopsy in early alcohol-related liver disease.
J Hepatol., (2021), 75 pp. 1017-1025
[24]
R. de Franchis, J. Bosch, G. García-Tsao, T. Reiberger, C. Ripoll, J.G. Abraldes, et al.
Baveno VII – Renewing consensus in portal hypertension.
J Hepatol., (2022), 76 pp. 959-974
[25]
S. Singh, S.K. Venkatesh, Z. Wang, F.H. Miller, U. Motosugi, R.N. Low, et al.
Diagnostic performance of magnetic resonance elastography in staging liver fibrosis: a systematic review and meta-analysis of individual participant data.
Clin Gastroenterol Hepatol., (2015), 13
[26]
C. Lackner, R.E. Stauber, S. Davies, H. Denk, H.P. Dienes, V. Gnemmi, et al.
Development and prognostic relevance of a histologic grading and staging system for alcohol-related liver disease.
J Hepatol., (2021), 75 pp. 810-819
[27]
A. O’Donnell, P. Anderson, D. Newbury-Birch, B. Schulte, C. Schmidt, J. Reimer, et al.
The impact of brief alcohol interventions in primary healthcare: A systematic review of reviews.
Alcohol Alcohol., (2014), 49 pp. 66-78
[28]
A.K. Singal, R. Bataller, J. Ahn, P.S. Kamath, V.H. Shah.
ACG clinical guideline: alcoholic liver disease.
Am J Gastroenterol., (2018), 113 pp. 175-194
[29]
Treatment of alcohol use disorder in patients with alcoholic liver disease.
Am J Med., (2017), 130 pp. 124-134
[30]
E.M. Burnette, S.J. Nieto, E.N. Grodin, L.R. Meredith, B. Hurley, K. Miotto, et al.
Novel agents for the pharmacological treatment of alcohol use disorder.
Drugs., (2022), 82 pp. 251-274
[31]
P. Kasper, S. Lang, H.M. Steffen, M. Demir.
Management of alcoholic hepatitis: A clinical perspective.
Liver Int., (2023), 43 pp. 2078-2095
[32]
D.E. Kleiner, E.M. Brunt.
Nonalcoholic fatty liver disease: pathologic patterns and biopsy evaluation in clinical research.
Semin Liver Dis., (2012), 32 pp. 3-13
[33]
S.R. Atkinson, J.I. Grove, S. Liebig, S. Astbury, N. Vergis, R. Goldin, et al.
In severe alcoholic hepatitis, serum keratin-18 fragments are diagnostic, prognostic, and theragnostic biomarkers.
Am J Gastroenterol., (2020), 115 pp. 1857-1868
[34]
D. Morales-Arráez, M. Ventura-Cots, J. Altamirano, J.G. Abraldes, M. Cruz-Lemini, M.R. Thursz, et al.
The MELD score is superior to the maddrey discriminant function score to predict short-term mortality in alcohol-associated hepatitis: A global study.
Am J Gastroenterol., (2022), 117 pp. 301-310
[35]
C. Moreno, P. Deltenre, C. Senterre, A. Louvet, T. Gustot, B. Bastens, et al.
Intensive enteral nutrition is ineffective for patients with severe alcoholic hepatitis treated with corticosteroids.
Gastroenterology., (2016), 1;150
[36]
J.P. Arab , L.A. Díaz, N. Baeza, F. Idalsoaga, E. Fuentes-López, J. Arnold, et al.
Identification of optimal therapeutic window for steroid use in severe alcohol-associated hepatitis: A worldwide study.
J Hepatol., (2021), 75 pp. 1026-1033
[37]
M. Thursz, A. Gual, C. Lackner, P. Mathurin, C. Moreno, L. Spahr, et al.
EASL clinical practice guidelines: Management of alcohol-related liver disease.
J Hepatol., (2018), 69 pp. 154-181
[38]
Alcohol-associated hepatitis.
N Engl J Med., (2022), 387 pp. 2436-2448
[39]
G. Szabo, M. Mitchell, C.J. McClain, S. Dasarathy, B. Barton, A.J. McCullough, et al.
IL-1 receptor antagonist plus pentoxifylline and zinc for severe alcohol-associated hepatitis.
Hepatology., (2022), 76 pp. 1058-1068
[40]
S. Singh, M.H. Murad, A.K. Chandar, C.M. Bongiorno, A.K. Singal, S.R. Atkinson, et al.
Comparative effectiveness of pharmacological interventions for severe alcoholic hepatitis: A systematic review and network meta-analysis.
Gastroenterology., (2015), 149
