Modest alcohol intake is not associated with significant hepatic steatosis nor more severe liver disease among patient with diabetes mellitus.

BACKGROUND The effect of modest alcohol intake on prevalence of significant hepatic steatosis and severity of liver disease in patients with type 2 diabetes mellitus (T2DM) is unclear. METHODS This is a cross-sectional study on T2DM patients. Modest alcohol intake was defined as alcohol intake ≤21 units per week in men and ≤14 units per week in women. Significant hepatic steatosis was diagnosed based on controlled attenuation parameter >263 dB/m while advanced fibrosis was diagnosed based on liver stiffness measurement ≥9.6 kPa using M probe or ≥9.3 kPa using XL probe. Patients with LSM ≥8.0 kPa were offered liver biopsy. RESULTS 557 patients underwent transient elastography and 71 patients underwent liver biopsy. The prevalence of modest drinking was 16.5%. Modest drinking was equally prevalent among ethnic Indians and Chinese at 22.9% and 23.3%, respectively, but uncommon among ethnic Malays at 1.7%. Modest drinkers were more likely to be male, smoked and had significantly lower HbA1c, total cholesterol, LDL cholesterol, alkaline phosphatase and platelet count. There was no significant difference in prevalence of significant hepatic steatosis or advanced fibrosis based on transient elastography, and steatohepatitis or advanced fibrosis between modest drinkers and non-drinkers. The prevalence of significant hepatic steatosis was higher among ethnic Malays and Indians compared with ethnic Chinese, but the Chinese did not have a lower prevalence of more severe liver disease. CONCLUSION Modest alcohol intake is not associated with higher prevalence of significant hepatic steatosis or more severe liver disease among patients with T2DM.