P-13 EVALUATION OF UNDIAGNOSED ALCOHOLIC LIVER DISEASE IN PATIENTS WITH METABOLIC DYSFUNCTION-ASSOCIATED FATTY LIVER DISEASE USING THE ANI SCORE

Conflict of interest No Introduction and Objectives The 2024 EASL-EASD-EASO guidelines on Steatotic Liver Disease emphasize the distinction between Metabolic Dysfunction-Associated Steatotic Liver Disease (MAFLD) and the subcategories with significant alcohol consumption: Alcoholic Liver Disease (ALD) and Metabolic ALD (MetALD). To this aim, a systematic record of alcohol consumption and/or validated biomarkers is recommended. To evaluate the likelihood of associated but unrecognized alcohol-related liver disease (MetALD/ALD) in patients managed for MAFLD. Patients / Materials and Methods A single-center retrospective study that analyzes the probability of MetALD/ALD using the ALD/NAFLD (ANI) score in patients diagnosed with MAFLD during May/June 2024. MAFLD was defined by the presence of hepatic steatosis with alcohol intake <20/30 g/day (iwomen/men), at least one cardiovascular risk factor, and no other discernible cause. Patients with suspected advanced chronic liver disease were excluded. A probability of MetALD/ALD was considered if ANI>0 (indicative of a probability >50%). Sociodemographic variables, alcohol consumption, and hepatic fibrosis were recorded and compared between the ANI>0 and ANI<0 groups, with significance level set at p<0.05. Results and Discussion 85 patients were included, average age 61.8±9.7 years, 52.9% male. Alcohol consumption was documented in medical history for 63.3% (54/85) of patients, with 53.4% (29/54) reporting no consumption. Per ANI score, 21.2% (18/85) were identified as having a probability of MetALD/ALD (ANI>0), with half of these (9/18) showing a probability >90%. Alcohol intake (10-20/30 g/day) was significantly higher in the ANI>0 group, consisting solely of males. Hepatic fibrosis was more pronounced in this group (7.6±3.6 vs 5.9±1.7) but did not reach statistical significance. Conclusions The significant prevalence of unrecognized MetALD/ALD by ANI score suggests that alcohol consumption may be underreported in the ANI>0 group. Therefore, the inclusion of the ANI score as a biomarker for accurate differentiation MAFLD from MetALD/ALD appears to be beneficial.