Editorial: Two Common Risks, One Greater Harm—Diabetes and Alcohol in Steatotic Liver Disease

作者：Stine Johansen, Nikolaj Torp, Mads Israelsen, Aleksander Krag · 发表于：Alimentary Pharmacology & Therapeutics · 年份：2026 · DOI：10.1111/apt.70744 · 被引用次数：1 · 研究领域：Liver Disease Diagnosis and Treatment、Alcohol Consumption and Health Effects、Drug-Induced Hepatotoxicity and Protection

The global rise of steatotic liver disease (SLD) reflects the converging epidemics of metabolic dysfunction and alcohol use [1]. In North America and Europe, nearly 90% of adults consume alcohol and more than 10% engage in harmful drinking [2], while over 2 billion adults are living with overweight or obesity globally [3]. These trends rarely occur in isolation. Instead, the overlapping presence of overweight, diabetes and harmful alcohol intake is increasingly the norm rather than the exception. The redefinition of SLD acknowledges this reality by framing the disease as a spectrum rather than as mutually exclusive entities [4]. Nonetheless, how the co-existence of these risk factors interacts to shape clinical outcomes remains incompletely understood. In this context, Zhou et al. used large prospective cohorts to examine the joint effects of type 2 diabetes (T2D) and alcohol consumption across the SLD spectrum [5]. The authors show that co-exposure substantially increases both all-cause and liver-related mortality, with the highest risks observed in individuals with T2D and alcohol-related liver disease. Notably, a significant interaction between T2D and alcohol was observed for liver-related mortality, but not for all-cause mortality. A limitation to consider here is that steatosis and thereby SLD was primarily identified using the Fatty Liver Index rather than imaging or histology, while fibrosis risk was estimated using FIB-4 rather than direct assessment. Beyond confirmi...