Many people drink alcohol regularly, but not everyone who drinks heavily develops serious liver disease. A new study from Keck Medicine of USC suggests that three common health conditions might explain why some drinkers are more at risk than others.
The research, published in Clinical Gastroenterology and Hepatology, found that heavy drinkers who have diabetes, high blood pressure, or a large waist size are much more likely to develop severe liver disease than those without these conditions.
According to the study, these individuals are up to 2.4 times more likely to suffer from liver scarring, which can lead to liver failure. Dr. Brian P. Lee, a liver specialist at Keck Medicine and the study’s lead researcher, explained that certain preexisting health issues may make the liver more vulnerable to alcohol-related damage.
These three risk factors—diabetes, high blood pressure, and a large waist—are part of a group of conditions known as cardiometabolic risk factors. These factors increase the chances of heart disease and strokes and are linked to fat buildup in the liver.
The condition, called metabolic dysfunction-associated steatotic liver disease (MASLD), can cause scarring, also known as fibrosis.
In recent years, more people in the U.S. have developed these risk factors, particularly young adults under 35. At the same time, alcohol consumption has increased, especially since the COVID-19 pandemic. This trend led Dr. Lee and his team to investigate how drinking interacts with these health conditions to affect liver health.
To conduct their research, the team analyzed data from a nationwide health survey that included over 40,000 people. They focused on heavy drinkers and examined how each cardiometabolic risk factor influenced the likelihood of developing liver fibrosis.
What Did They Find?
The study defined heavy drinking as more than 1.5 alcoholic drinks per day for women and more than two drinks per day for men. The results showed that heavy drinkers with either diabetes or a large waist size were 2.4 times more likely to develop advanced liver disease. Those with high blood pressure were 1.8 times more likely.
Interestingly, the other two common cardiometabolic risk factors—high triglycerides (a type of fat in the blood) and low HDL cholesterol (the “good” cholesterol)—were not as strongly linked to liver disease in heavy drinkers.
While the study did not explore the exact reasons why diabetes, high blood pressure, and large waist size are so harmful to the liver, Dr. Lee believes that these conditions all contribute to excess fat buildup in the liver. When combined with fat deposits from heavy drinking, the damage can become severe.
What This Means for Drinkers
Dr. Lee stresses that the findings do not mean drinking is safe for people without these risk factors. Alcohol is always harmful to the liver, especially in large amounts. However, people with diabetes, high blood pressure, or a large waist should be especially careful, as they face a much higher risk of serious liver damage.
He hopes this research will encourage people to think about their overall health when deciding how much alcohol to consume. He also suggests that doctors screen heavy drinkers with these risk factors more closely. Early detection of liver problems could help prevent serious disease and allow for better treatment options.
Dr. Norah Terrault, a gastroenterologist and liver specialist at Keck Medicine, also contributed to the study.
Review and Analysis
This study highlights the complex relationship between alcohol and preexisting health conditions. Many people assume that liver disease from alcohol only happens to extreme drinkers, but this research shows that underlying health conditions can significantly increase risk, even at moderate levels of heavy drinking.
The findings are particularly concerning given the rising rates of obesity, diabetes, and high blood pressure in the U.S. Since many people may not realize they have these conditions, they might unknowingly be putting their liver at risk when they drink.
A key takeaway from the study is that liver damage is not just about how much someone drinks—it’s also about their overall health. People with these risk factors should be more cautious about alcohol, and healthcare providers should consider these factors when advising patients on alcohol use.
While the study provides valuable insights, more research is needed to fully understand why certain conditions make the liver more vulnerable to alcohol. Future studies could explore whether lifestyle changes, such as weight loss, better diet, or medication, might reduce the risk of alcohol-related liver disease for people with these conditions.
Overall, this study is a strong reminder that alcohol affects everyone differently. Being aware of personal health risks can help people make more informed choices about drinking and protect their long-term liver health.
If you care about liver health, please read studies about simple habit that could give you a healthy liver, and common diabetes drug that may reverse liver inflammation.
For more information about health, please see recent studies about simple blood test that could detect your risk of fatty liver disease, and results showing this green diet may strongly lower non-alcoholic fatty liver disease.
The research findings can be found in Clinical Gastroenterology and Hepatology.
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