{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T14:07:18Z","timestamp":1775743638622,"version":"3.50.1"},"reference-count":36,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The real-world risk profiles of newly defined steatotic liver disease (SLD) subtypes\u2014MASLD, MetALD, and ALD\u2014remain incompletely described in community settings. Methods: A cross-sectional analysis of 950 health-checkup participants was conducted. SLD (CAP \u2265 248 dB\/m) and significant fibrosis (LSM \u2265 7.0 kPa) were evaluated by transient elastography. Associations between alcohol intake, cardiometabolic factors, fibrosis, and gut microbiota (16S rRNA sequencing) were assessed. Results: Among 950 participants, 310 (33%) had SLD (MASLD, n = 222; MetALD, n = 41; ALD, n = 23). Treated as a continuous exposure, higher alcohol intake was significantly correlated with elevated systolic\/diastolic blood pressure, triglycerides, AST, and \u03b3-GTP, but inversely correlated with HOMA-IR (all p &lt; 0.05). In multivariable logistic regression adjusting for cardiometabolic factors, BMI was the only independent predictor of fibrosis (adjusted OR 1.22, 95% CI 1.11\u20131.35, p &lt; 0.01), whereas alcohol intake showed no independent association. Furthermore, microbiota analysis revealed that ALD-related SLD was characterized by significant depletion of Blautia and enrichment of Gemella (FDR q &lt; 0.05) compared to non-SLD controls, indicating an alcohol-associated dysbiosis signature. Conclusions: In early-stage SLD, alcohol intake continuously exacerbates cardiometabolic risk factors, whereas fibrosis is predominantly driven by BMI. These findings support quantitative alcohol\/BMI integration for risk stratification, alongside microbiota profiling to detect ALD-related dysbiosis.<\/jats:p>","DOI":"10.3390\/jcm15082860","type":"journal-article","created":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T13:09:31Z","timestamp":1775740171000},"page":"2860","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Alcohol Intake, Cardiometabolic Risk, Fibrosis, and Gut Microbiota in Steatotic Liver Disease: A Population-Based Health Checkup Study"],"prefix":"10.3390","volume":"15","author":[{"given":"Keisuke","family":"Furusawa","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Hematology, and Clinical Immunology, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chikara","family":"Iino","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hematology, and Clinical Immunology, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keita","family":"Mikami","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hematology, and Clinical Immunology, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5569-7093","authenticated-orcid":false,"given":"Satoshi","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hematology, and Clinical Immunology, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3897-5546","authenticated-orcid":false,"given":"Kenta","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hematology, and Clinical Immunology, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4190-5151","authenticated-orcid":false,"given":"Shigeyuki","family":"Nakaji","sequence":"additional","affiliation":[{"name":"Department of Preemptive Medicine, Innovation Center for Health Promotion, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6657-6446","authenticated-orcid":false,"given":"Tatsuya","family":"Mikami","sequence":"additional","affiliation":[{"name":"Department of Preemptive Medicine, Innovation Center for Health Promotion, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirotake","family":"Sakuraba","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hematology, and Clinical Immunology, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1966","DOI":"10.1097\/HEP.0000000000000520","article-title":"A multi-society Delphi consensus statement on new fatty liver disease nomenclature","volume":"78","author":"Rinella","year":"2023","journal-title":"Hepatology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1016\/j.jhep.2020.03.039","article-title":"A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement","volume":"73","author":"Eslam","year":"2020","journal-title":"J. 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