Pilot study on the assessment of unrecognized alcoholic liver disease in patients with metabolic dysfunction-associated steatotic liver disease using the ANI score.

This pilot study evaluates the presence of potential unrecognized steatotic liver disease with moderate alcohol consumption (MetALD) in patients diagnosed with metabolic dysfunction-associated steatotic liver disease (MASLD) using the ALD/NAFLD index (ANI) score. A retrospective single-center study was conducted on 85 patients attending Digestive Diseases consultations in May and June 2024. MASLD was defined by hepatic steatosis with limited alcohol intake (<20 g/day for women and <30 g/day for men) and at least one cardiovascular risk factor. The ANI score identified 21.2% of patients as having a potential probability of MetALD, with higher alcohol consumption (10-30 g/day) and increased liver fibrosis observed in this group, though the latter did not reach statistical significance. Even though the ANI score is not validated to distinguish MetALD from MASLD, our findings highlight its potential utility in improving diagnostic accuracy by addressing underreported alcohol consumption.