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A new study from Keck Medicine of USC sheds light on why some individuals who consume alcohol heavily develop advanced liver disease while others do not. According to the study, published in Clinical Gastroenterology and Hepatology, three common underlying medical conditions—diabetes, high blood pressure, and a high waist circumference—may significantly increase the risk of liver damage in heavy drinkers.
Understanding the Risk Factors
The research, led by Brian P. Lee, MD, MAS, a hepatologist and liver transplant specialist, found that individuals with these cardiometabolic risk factors are up to 2.4 times more likely to develop advanced liver disease. The study analyzed data from the National Health and Nutrition Examination Survey, which included over 40,000 participants, and examined the intersection of heavy drinking, cardiometabolic risk factors, and significant liver fibrosis (scarring of the liver that can lead to failure).
Cardiometabolic risk factors—conditions that increase the likelihood of heart attack and stroke—are linked to the accumulation of fat in the liver, known as metabolic dysfunction-associated steatotic liver disease (MASLD). This fat buildup, exacerbated by alcohol consumption, can lead to severe liver damage over time.
Alcohol and Liver Health
Lee and his team found that individuals with diabetes or a high waist circumference (over 35 inches for women and 40 inches for men) who drink heavily face a 2.4 times higher risk of developing advanced liver disease. Those with high blood pressure were 1.8 times more likely to develop liver fibrosis. While other factors such as high triglycerides and low HDL (“good” cholesterol) were considered, they showed less significant correlations to liver disease.
“The results identify a very high-risk segment of the population prone to liver disease and suggest that preexisting health issues may have a large impact on how alcohol affects the liver,” said Lee.
The study did not delve into the precise biological mechanisms at play, but Lee speculates that diabetes, obesity-related high waist circumference, and hypertension contribute to fat accumulation in the liver. When combined with alcohol-related fat deposits, this leads to severe liver damage.
Implications for Public Health
The findings highlight the importance of personalized health assessments when making decisions about alcohol consumption. Lee hopes this research will encourage both individuals and healthcare providers to consider cardiometabolic risks when evaluating alcohol use.
“We know that alcohol is toxic to the liver, and all heavy drinkers are at risk for advanced liver disease,” Lee emphasized. “However, individuals with diabetes, high blood pressure, or obesity should be particularly cautious.”
Norah Terrault, MD, a Keck Medicine gastroenterologist and co-author of the study, stressed the need for early detection and intervention for those at high risk. “Personalized screenings can help identify liver damage early and potentially prevent severe outcomes.”
Conclusion
As alcohol consumption continues to rise—especially since the COVID-19 pandemic—understanding individual risk factors is crucial. This study reinforces the need for targeted medical screenings and lifestyle interventions for those at greater risk due to underlying health conditions.
Disclaimer:
This article is for informational purposes only and does not constitute medical advice. Readers should consult healthcare professionals regarding any concerns about alcohol consumption and liver health.
