Which Drinking Patterns Predict Alcoholic Cirrhosis?

Relatively recent patterns of alcohol consumption, not lifetime patterns of consumption, play the primary role in determining which drinkers develop the potentially lethal condition called alcoholic cirrhosis, according to new research from a team of Danish scientists.

Alcoholic cirrhosis is the most advanced and potentially deadly form of a group of drinking-related conditions known collectively as alcoholic liver disease. Broadly speaking, people affected by long-term alcoholism have the highest chances of developing this severe condition. In a study published in January 2015 in the Journal of Hepatology, researchers from three Danish institutions examined the specific patterns of alcohol use that carry the most risk for the onset of alcoholic cirrhosis. These researchers found that patterns of consumption in the more recent decades of adulthood have substantially more impact than patterns of consumption in earlier decades of adulthood.

Alcoholic Cirrhosis

Cirrhosis is the general medical/scientific term used to describe permanent scarring in liver tissue. People affected by alcoholic cirrhosis have permanent liver scarring linked to the excessive and typically prolonged consumption of alcohol. Since the liver is one of the body’s primary organs for blood cleansing and detoxification, scarred liver tissue can seriously disrupt an individual’s general health and may ultimately contribute to the onset of liver failure.

Roughly 10 percent to 20 percent of all people affected by alcoholism will develop cirrhosis. The condition is much more uncommon than the first stage of alcoholic liver disease, known as fatty liver disease. It also generally occurs less often than the second stage of alcoholic liver disease, known as alcoholic hepatitis (i.e., alcohol-related liver inflammation), although cases of alcoholic hepatitis and alcoholic cirrhosis can overlap. Most people with alcoholic cirrhosis have a decades-long history of frequent and excessive alcohol intake. In combination with liver scarring, major health changes associated with the condition include localized high blood pressure, shrinkage in the size of the liver, acute kidney failure, a form of cancer called hepatocellular carcinoma and liver failure-related end-stage liver disease.

Drinking Patterns

Drinking pattern includes the amount of alcohol consumed per day and per week, as well as the frequency of weekly or monthly alcohol intake. Depending on their specific drinking patterns, all alcohol consumers qualify as light drinkers, moderate drinkers or heavy drinkers. For the most part, light and moderate drinkers avoid the major risks associated with alcohol intake. Heavy drinkers, however, substantially increase their chances of developing alcoholism or diagnosable, non-addicted alcohol abuse. For men, the minimum standard for heavy drinking is regular consumption of five or more alcohol servings on a single day or regular weekly consumption of 15 or more alcohol servings. Women have a minimum heavy drinking standard based on the regular consumption of four or more alcohol servings per day or the regular weekly consumption of eight or more alcohol servings.

Which Patterns Promote Alcoholic Cirrhosis?

In the study published in the Journal of Hepatology, researchers from Denmark’s Copenhagen University Hospital, University of Southern Denmark and Danish Cancer Society Research Center used data gathered from 55,917 adults from 1993 to 2011 to help determine which patterns of alcohol intake have the greatest impact on the chances of developing alcoholic cirrhosis. Specific calculations used by these researchers included the frequency of alcohol use, the types of alcohol typically consumed, the amount of alcohol consumed over the course of a lifetime and the amount of alcohol consumed in specific decades of early adulthood or middle age.

The researchers concluded that drinkers who consume alcohol every day or nearly every day have much higher chances of developing alcoholic cirrhosis than drinkers who consume alcohol only two to four days per week. They also concluded that recent patterns of daily or non-daily alcohol use have a substantially larger impact on alcoholic cirrhosis risks than a person’s overall lifetime pattern of use. Specifically, drinking patterns maintained throughout an individual’s 40s and 50s considerably influence the odds of developing alcohol-related liver scarring, while drinking patterns maintained throughout that individual’s 20s and 30s do not.

The study mostly focused on men; however, its authors concluded that the same basic findings apply to women who consume alcohol. In addition to light and moderate drinkers, groups of alcohol consumers with notably low risks for alcoholic cirrhosis include people who largely consume wine rather than beer or liquor.

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