The Higher Prevalence of Non-Alcoholic versus Alcoholic Steatohepatitis in Alcoholics

BACKGROUND: The aim of this study was to evaluate the prevalence of alcoholic (ASH) and non-alcoholic steatohepatitis (NASH) in alcoholics by non-invasive biochemical markers: AshTest and NashTest. METHODS: The tested group consisted of 142 alcoholic patients. All biochemical markers were assessed using the recommended methods. RESULTS: The highest values of AshTest and NashTest were observed in the highest H3 score and N2 score, respectively. The distribution of AshTest scores was the following: H0 - 94.1%, H1 - 5.2%, H2 - 0%, and H3 - 0.7%, while for NashTest was: N0 - 56.6%, N1 - 38.2% and N2 - 5.1%. In summary, alcoholic steatohepatitis was present only in 5.9% of alcoholics and non-alcoholic steatohepatitis in 43.3% of patients. Co-occurrence of ASH and NASH was observed in 3.7% of patients. The BMI, mean glucose, and triglyceride levels were significantly different between NashTest scores, but not between AshTest scores. These results may evidence that non-alcoholic steatohepatitis is associated with metabolic risk factors such as diabetes mellitus, dyslipidemia, and obesity. The MCV value and AST/ALT ratio were higher in alcoholic steatohepatitis than in non-alcoholic steatohepatitis. CONCLUSIONS: In conclusion, the prevalence of non-alcoholic steatohepatitis in alcoholics is higher than of alcoholic steatohepatitis, as estimated by non-invasive tests. Co-occurrence of alcoholic steatohepatitis and non-alcoholic steatohepatitis in alcoholic patients is low and the high prevalence of non-alcoholic steatohepatitis is related with high occurrence of metabolic risk factors.