Clinical differences between alcoholic liver disease and nonalcoholic fatty liver disease

Abstract

Alcoholic liver disease (ALD) and nonalcoholic fatty liver disease (NAFLD) are serious health problems worldwide. These two diseases have similar pathological spectra, ranging from simple hepatic steatosis to steatohepatitis, liver cirrhosis, and hepatocellular carcinoma. Although most subjects with excessive alcohol or food intake experience simple hepatic steatosis, a small percentage of individuals will develop progressive liver disease. Notably, both ALD and NAFLD are frequently accompanied by extrahepatic complications, including cardiovascular disease and malignancy. The survival of patients with ALD and NAFLD depends on various disease-associated conditions. This review delineates the clinical characteristics and outcomes of patients with ALD and NAFLD by comparing their epidemiology, the factors associated with disease susceptibility and progression, and the predictors and characteristics of outcomes. A comprehensive understanding of the characteristics and outcomes of ALD and NAFLD is imperative in the management of these chronic liver diseases.

Keywords: Alcoholic liver disease, Nonalcoholic fatty liver disease, Clinical characteristics, Outcomes, Chronic liver disease

Core tip: Although alcoholic liver disease (ALD) and nonalcoholic fatty liver disease (NAFLD) have similar pathological spectra, from simple hepatic steatosis to steatohepatitis and liver cirrhosis, the epidemiological and clinical characteristics of these two diseases differ. Comparative analyses of the factors associated with disease susceptibility and progression and the predictors and characteristics of outcomes would be helpful in the management of these diseases. Notably, both ALD and NAFLD are frequently accompanied by extrahepatic complications, including cardiovascular disease and malignancy, which can influence patient survival.