Patients diagnosed with metabolic dysfunction-associated steatotic liver disease (MASLD) who engage in heavy drinking at least once a month face a threefold higher risk of developing advanced liver fibrosis. This finding comes from a 2026 cross-sectional study conducted in the USA.
Researchers analyzed data from the National Health and Nutrition Examination Survey, defining episodic heavy drinking as consuming four or five drinks for women and men, respectively, on a single occasion, at least once per month. The study examined over 8,000 individuals, including those with MASLD, steatotic liver disease (SLD), MetALD, and alcohol-associated liver disease (ALD).
Significant and advanced fibrosis were identified based on liver stiffness measurements. The analysis showed that MASLD patients who drink heavily episodically are 1.69 to 2.76 times more likely to develop significant and advanced liver fibrosis compared to those who consume alcohol more moderately. Younger adults and men were more frequently identified as engaging in episodic heavy drinking.
The study highlights that current SLD nomenclature primarily considers average alcohol consumption, potentially underestimating the impact of binge drinking. Reclassifying MASLD patients who binge drink could significantly alter the estimated prevalence of MetALD in the US, emphasizing the need for improved risk stratification strategies.