A recent study in Clinical Gastroenterology and Hepatology from researchers at Keck Medicine of USC sheds light on a pressing question: why do certain heavy drinkers suffer severe liver disease while others seem unaffected? The research identifies three major medical conditions—diabetes, hypertension, and increased waist circumference—as critical risk factors that can heighten the odds of developing advanced liver issues.
It turns out that heavy drinkers with these conditions are significantly more vulnerable—up to 2.4 times more likely to experience severe liver disease.
Identifying Key Risk Factors
Dr. Brian P. Lee, a hepatologist at Keck Medicine and the study’s lead author, emphasizes that individuals with pre-existing health challenges are particularly at risk for alcohol-related liver complications.
His findings show that the interplay between these existing conditions and alcohol consumption can severely impact liver health.
The health issues mentioned—diabetes, high blood pressure, and abdominal obesity (defined as a waist measurement of 35 inches or more in women and 40 inches or more in men)—are part of a broader category known as cardiometabolic risks.
These risks not only increase the likelihood of liver problems but also raise the potential for heart disease and stroke.
Alarmingly, these conditions are on the rise in the U.S., especially among people under 35.
The Connection Between Alcohol and Liver Health
The study points out that these cardiometabolic risks can lead to fat buildup in the liver, which is associated with a condition called metabolic dysfunction-associated steatotic liver disease.
When this condition progresses, it can result in fibrosis, a serious scarring of the liver.
In light of increased alcohol consumption trends following the COVID-19 pandemic, researchers sought to investigate which of these cardiometabolic issues most significantly enhance the liver’s vulnerability to damage from alcohol.
They analyzed data from over 40,000 participants in the National Health and Nutrition Examination Survey, examining the links between heavy drinking, cardiometabolic conditions, and the risk of significant liver fibrosis that can culminate in liver failure.
Heavy drinking was defined in the study as consuming 1.5 alcoholic drinks daily for women and two drinks daily for men.
The findings were striking: heavy drinkers with diabetes or a large waist circumference were over two times more likely to experience advanced liver disease than their healthier peers.
Additionally, those with hypertension saw their risk increase by 1.8 times.
Interestingly, the impact of elevated triglycerides and low HDL cholesterol on liver issues appeared to be less significant.
Implications for Health and Safety
While the research didn’t delve deeply into why these specific cardiometabolic factors pose higher risks for liver health, Dr. Lee speculates that they may operate through a similar underlying mechanism that causes fat to accumulate in the liver.
When heavy alcohol intake adds to this fat, it can lead to severe liver impairment.
It’s essential to note that the study does not imply that individuals without these specific cardiometabolic conditions can safely indulge in heavy drinking. Dr. Lee reinforces the long-standing understanding that alcohol is detrimental to liver health, affecting all heavy drinkers, regardless of other health issues.
The researchers hope their work encourages individuals to consider their health status when making decisions about alcohol consumption. Dr. Lee advocates for healthcare providers to carry out personalized health assessments and propose interventions for heavy drinkers, especially those carrying cardiometabolic risk factors.
This approach could lead to earlier detection and treatment of potential liver damage in this at-risk population.
Dr. Norah Terrault, a gastroenterologist at Keck Medicine and co-author of the study, also contributes valuable insights to these important findings.
Source: ScienceDaily