Karn WijarnpreechaElizabeth S. AbyPanadeekarn PanjawatananKamolyut LapumnuaypolWisit CheungpasitpornFrank J. LukensDenise M. HarnoisPatompong UngprasertSiriraj HospitalAlbert Einstein Medical CenterDavid Geffen School of Medicine at UCLAUniversity of Mississippi Medical CenterMayo Clinic in Jacksonville, FloridaChiang Mai University2022-08-042022-08-042021-07-16Annals of Gastroenterology. Vol.34, No.4 (2021), 568-57417927463110874712-s2.0-85112077920https://repository.li.mahidol.ac.th/handle/20.500.14594/78031Background Recent studies have suggested an association between modest alcohol consumption and a decreased risk of advanced liver fibrosis among patients with nonalcoholic fatty liver disease (NAFLD) although the results are inconsistent. The current systematic review and meta-analysis was conducted to comprehensively investigate this possible association by identifying all the relevant studies and combining their results. Methods A comprehensive literature review was conducted utilizing the MEDLINE and EMBASE databases through February 2019 to identify all cross-sectional studies that compared the prevalence of advanced liver fibrosis among NAFLD patients who were modest alcohol drinkers to NAFLD patients who were non-drinkers. Effect estimates from each study were extracted and combined together using the random-effect, generic inverse variance method of DerSimonian and Laird. Results A total of 6 studies with 8,936 participants fulfilled the eligibility criteria and were included in the meta-analysis. The risk of advanced liver fibrosis among patients with NAFLD who were modest alcohol drinkers was significantly lower compared to patients with NAFLD who were non-drinkers with a pooled odds ratio of 0.51 (95% confidence interval [CI] 0.35-0.75; I2 47%). The funnel plot was symmetric and was not suggestive of publication bias. Conclusion A significantly lower risk of advanced liver fibrosis was observed among NAFLD patients who were modest alcohol drinkers compared to non-drinkers in this meta-analysis.Mahidol UniversityMedicineArticleSCOPUS10.20524/aog.2021.0612