# Alcohol Abstinence Is Associated with Regression of Non-Invasive Fibrosis Markers in Patients with Metabolic Syndrome: A 12-Month Prospective Study

## TL;DR

Stopping alcohol consumption improves liver health markers in people with metabolic syndrome over 12 months.

## Contribution

Shows real-world benefits of alcohol abstinence on liver fibrosis in metabolic syndrome patients.

## Key findings

- Abstinent patients showed significant improvement in liver stiffness and fibrosis markers after 12 months.
- Non-abstinent patients experienced worsening of fibrosis markers over time.
- Gamma-glutamyl transferase levels were linked to baseline fibrosis severity.

## Abstract

Background: Patients with metabolic syndrome represent a particularly vulnerable population for alcohol-related liver disease progression. However, real-world longitudinal data evaluating the impact of alcohol abstinence on liver fibrosis dynamics in this group remain limited. Methods: We conducted a prospective observational study including hospitalized adults with metabolic syndrome and chronic alcohol consumption. Clinical, laboratory, and non-invasive fibrosis markers—fibrosis-4 index (FIB-4), aspartate aminotransferase-to-platelet ratio index (APRI), and transient elastography—were assessed at baseline and after 6 and 12 months of individual follow-up. Patients were classified according to alcohol consumption status during follow-up. Longitudinal and comparative analyses were performed. Results: At baseline, patients were classified as having alcoholic steatosis (56.3%), alcoholic steatohepatitis (25.0%), or alcoholic cirrhosis (18.7%). During follow-up, 72.9% of patients achieved sustained alcohol abstinence. Abstinent patients demonstrated significant improvements in liver stiffness, FIB-4, and APRI scores at 12 months (all p < 0.001), while non-abstinent patients showed progressive worsening of fibrosis markers. Gamma-glutamyl transferase levels were independently associated with fibrosis severity at baseline. Conclusions: This prospective real-world study suggests that alcohol abstinence is associated with favorable longitudinal changes in non-invasive liver fibrosis markers in patients with metabolic syndrome. Given the non-invasive nature of the diagnostic approach and the relatively small sample size, these findings should be considered hypothesis-generating. Further studies with larger cohorts are warranted to better elucidate the interaction between metabolic risk factors, alcohol consumption, and liver disease progression.