过量饮酒对代谢功能障碍相关脂肪肝病（MAFLD）预后的影响仍不清楚。我们根据患有 MAFLD 的亚洲人的饮酒量调查了全因死亡率和特定原因死亡率。这项全国性回顾性研究纳入了 996,508 名 40-79 岁的成年人，他们在 2009 年至 2012 年间接受了健康检查。参与者按以下分类：饮酒量——非酒精、中度酒精和重度酒精组（男性≥ 30克/天，女性 ≥ 20克/天）以及是否存在MAFLD的组合。肝脂肪变性定义为脂肪肝指数 ≥ 30。采用Cox分析分析饮酒与MAFLD以及全因和特定原因死亡率之间的关联。MAFLD显着增加全因、肝脏和癌症相关死亡率。与非 MAFLD 和非酒精组相比，同时患有 MAFLD 和大量饮酒的个体在肝脏相关死亡方面表现出最高的死亡风险（调整后风险比 (HR)，9.8；95% 置信区间 (CI)，8.20-12.29） 。无论 MAFLD 如何，大量饮酒都会增加肝癌和癌症相关死亡率的风险。MAFLD 和大量饮酒会增加全因、肝癌和癌症相关死亡率。大量饮酒和 MAFLD 会协同增加肝脏相关死亡率。© 2024。亚太肝脏研究协会。

The effects of excessive alcohol consumption on the prognosis of metabolic dysfunction-associated fatty liver disease (MAFLD) remain unclear. We investigated all-cause and cause-specific mortality according to the amount of alcohol consumed by Asian individuals with MAFLD.This nationwide retrospective study included 996,508 adults aged 40-79 years who underwent health check-ups between 2009 and 2012. Participants were categorized by the alcohol consumption-non-alcohol, moderate alcohol, and heavy alcohol group (≥ 30 g/day for men, ≥ 20 g/day for women) and by the combination of the presence or absence of MAFLD. Hepatic steatosis was defined as the fatty liver index ≥ 30. Cox analyses were used to analyze the association between alcohol consumption and MAFLD and all-cause and cause-specific mortality.MAFLD significantly increased all-cause, liver-, and cancer-related mortality. Individuals with both MAFLD and heavy alcohol consumption expressed the highest mortality risk in liver-related mortality compared to non-MAFLD and non-alcohol group (adjusted hazard ratio (HR), 9.8; 95% confidence interval (CI), 8.20-12.29). Regardless of MAFLD, heavy alcohol consumption increased the risk of liver- and cancer-related mortality.MAFLD and heavy alcohol consumption increased all-cause, liver-, and cancer-related mortality. Heavy alcohol consumption and MAFLD synergistically increase liver-related mortality.© 2024. Asian Pacific Association for the Study of the Liver.