ABSTRACT

Metabolic dysfunction-associated steatotic liver disease (MASLD) affects more than 18 million individuals in Germany. Life-style choices including alcohol, coffee and smoking are frequent but prospective data are rare.The German SLD-Registry aims to describe clinical characteristics and observe outcomes in secondary and tertiary care. Detailed data on life-style choices are prospectively collected.Baseline data of 903 patients were analysed. 40% (363/903) reported low grade alcohol consumption (mean 1.4 g/day). The alcohol subgroup had higher ferritin (152 vs. 205 ng/ml) but less frequently high-risk fibrosis scores (FIB-4 >2.67 8.5 vs. 15%; NFS >0.675 9.3 vs. 17%) or LS ≥9.6 kPa (25 vs. 73%; OR 0.546 [0.41-0.73], p<0.001). Smokers (current 83/544, former 136/544) had a trend towards higher CAP (326 and 314 vs. 305dB in never smokers (325/544)). No association of smoking to LS ≥9.6 kPa or cirrhosis stage could be observed (OR 0.94 [0.62-1.43], p=0.78). LS ≥9.6 kPa tended to be less frequent in coffee consumers (1-2 cups/day 229/464, 3-4 cups/day 117/464, >5 cups/day 36/464) than in non-consumers (36, 23 and 28% vs. 45%). CAP was not different between these groups. The OR for coffee consumers was reduced (0.58 [0.97-0.34]; p=0.04) with a significant dose dependency (p<0.003).Alcohol and coffee consumption are frequent among MASLD patients. Low grade alcohol and any degree coffee consumption were associated with a decreased risk of advanced liver fibrosis. Our data may confirm the beneficial effects of coffee and indicate that very low alcohol consumption may at least not exert relevant unfavourable effects.

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