Alcohol consumption, even at moderate levels, affects the function of adipose tissue
Hazardous alcohol consumption causes marked adipose tissue inflammation, similar to changes seen in obesity
Adipose tissue inflammation caused by alcohol contributes to the progression of liver disease through effects on liver function, inflammation and fibrosis
If alcohol abuse and obesity are both present, risk of liver-related morbidity and mortality is increased
Hazardous drinkers are at increased risk of the clinical sequelae of adipose tissue inflammation, particularly type 2 diabetes mellitus
In addition to abstinence from alcohol, addressing adipose tissue inflammation through exercise or medications could improve liver disease
Adipose tissue represents a large volume of biologically active tissue that exerts substantial systemic effects in health and disease. Alcohol consumption can profoundly disturb the normal functions of adipose tissue by inducing adipocyte death and altering secretion of adipokines, pro-inflammatory mediators and free fatty acids from adipose tissue, which have important direct and indirect effects on the pathogenesis of alcoholic liver disease (ALD). Cessation of alcohol intake quickly reverses inflammatory changes in adipose tissue, and pharmacological treatment that normalizes adipose tissue function improves experimental ALD. Obesity exacerbates liver injury induced by chronic or binge alcohol consumption, and obesity and alcohol can synergize to increase risk of ALD and progression. Physicians who care for individuals with ALD should be aware of the effects of adipose tissue dysfunction on liver function, and consider strategies to manage obesity and insulin resistance. This Review examines the effect of alcohol on adiposity and adipose tissue and the relationship between alcohol, adipose tissue and the liver.
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The work from the lab of B.G. described in this Review was supported by the intramural program of National Institute on Alcohol Abuse and Alcoholism, NIH.
The authors declare no competing financial interests.
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Parker, R., Kim, SJ. & Gao, B. Alcohol, adipose tissue and liver disease: mechanistic links and clinical considerations. Nat Rev Gastroenterol Hepatol 15, 50–59 (2018). https://doi.org/10.1038/nrgastro.2017.116
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