title: Effects of light-to-moderate alcohol consumption on steatosis and steatohepatitis in severely obese patients.
abstract: OBJECTIVE
  The effect of light-to-moderate alcohol consumption (LMAC) in nonalcoholic fatty liver disease (NAFLD) remains a controversial subject. The aim of this study was to evaluate the relationship between LMAC and the severity of NAFLD in morbidly obese patients.
  
  
  METHODS
  We studied 132 patients undergoing liver biopsy during bariatric surgery. The patients were divided into three groups: G1: alcohol intake greater than 20 g/day and less than 40 g/day; G2: alcohol intake less than 20 g/day; G3: no alcohol intake. Insulin resistance was defined by the Homeostasis Model Assessment (>3). NAFLD was classified according to the Matteoni types: type I: steatosis alone; type II: steatosis with inflammation; types III-IV: steatosis with ballooning and/or fibrosis.
  
  
  RESULTS
  The mean age was 37.3+/-11 years. Sixty-three percent were females and body mass index was 43.9+/-5.6 kg/m. G1, G2, and G3 included 19, 56, and 57 patients, respectively. Histological diagnoses classified by levels of alcohol were: G1: 10.5% normal liver, 89.5% type III or IV; G2: 10.7% normal liver, 1.8% type I or II, and 87.5% grade III or IV; G3: 10.5% normal liver, 3.5% type I or II, and 86% type III or IV (one had cirrhosis). The presence of IR was similar in moderate and no alcohol consumption (81.3 and 78.7%) but significantly less in the light consumption group (54%, P<0.05).
  
  
  CONCLUSIONS
  The results suggest that LMAC may have a protection effect against IR in severely obese patients. However, it had no impact on the severity of activity and stage of liver disease.
authors.affiliation: Postgraduate Course in Medicine and Health, Universidade Federal da Bahia, Bahia, Brazil. hpcotrim@ufba.br
authors.forename: Helma P
authors.initials: HP
authors.lastname: Cotrim
authors.forename: Luiz Antônio
authors.initials: LA
authors.lastname: Freitas
authors.forename: Erivaldo
authors.initials: E
authors.lastname: Alves
authors.forename: Alessandro
authors.initials: A
authors.lastname: Almeida
authors.forename: Daniel S
authors.initials: DS
authors.lastname: May
authors.forename: Stephen
authors.initials: S
authors.lastname: Caldwell
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects*; D050110:Bariatric Surgery; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000188:drug therapy / Q000473:pathology*; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications* / Q000188:drug therapy; D055815:Young Adult