Many people enjoy alcohol regularly, but not everyone who drinks a lot ends up with serious liver problems.
A new study from Keck Medicine of USC helps explain why. It found that certain health conditions—diabetes, high blood pressure, and having a large waist—make heavy drinkers much more likely to get severe liver disease.
The study was published in Clinical Gastroenterology and Hepatology. It showed that heavy drinkers with these health issues are up to 2.4 times more likely to develop liver scarring, which can lead to liver failure. Dr. Brian P. Lee, a liver doctor and the lead researcher, said that these common health problems may make the liver more sensitive to alcohol damage.
These three risk factors are part of what’s called “cardiometabolic risk factors.” They are already known to raise the chances of heart disease and stroke, and they are linked to fat building up in the liver. This fat buildup can cause a condition known as MASLD (metabolic dysfunction-associated steatotic liver disease), which can lead to liver scarring.
The number of people with diabetes, high blood pressure, and obesity has gone up in recent years, especially in younger adults. At the same time, alcohol use has increased, particularly since the COVID-19 pandemic. That’s why the researchers wanted to explore how drinking and these health conditions together affect liver health.
They looked at data from over 40,000 people in a national health survey. The study focused on those who drank heavily. That means more than 1.5 alcoholic drinks per day for women and more than 2 drinks per day for men. The team then checked how each health condition affected the chance of developing liver scarring.
Here’s what they found: heavy drinkers with diabetes or a large waist size were 2.4 times more likely to have serious liver problems. Those with high blood pressure were 1.8 times more likely. Other conditions like high triglycerides and low HDL cholesterol didn’t show as strong a connection.
The study didn’t explore all the reasons why these specific conditions raise liver risk. But Dr. Lee explained that all three lead to fat buildup in the liver. When that’s mixed with fat from alcohol, it makes the liver more likely to get damaged.
So what does this mean for people who drink? Dr. Lee said that alcohol is never fully safe for the liver, especially when people drink heavily. But for those who also have diabetes, high blood pressure, or a big waist, the risk is even higher. These people should be especially cautious with alcohol.
He also hopes the study will help doctors do a better job of checking the liver health of heavy drinkers who have these health conditions. Spotting problems early could lead to better care and less serious disease.
Dr. Norah Terrault, another liver specialist at Keck Medicine, also helped with the study.
This research shows that liver damage isn’t only about how much someone drinks. It’s also about their overall health. Even people who don’t think they drink “too much” might be at higher risk if they have one of these health problems.
As obesity, diabetes, and high blood pressure become more common, many people may be hurting their liver without realizing it. That’s why it’s important to know your health risks and think carefully about how alcohol fits into your life.
More research is needed to understand why these conditions make the liver more sensitive to alcohol. Scientists also want to know if losing weight, eating better, or taking medicine could reduce this risk.
In the end, this study is a strong reminder that alcohol affects people differently. By knowing your risks, you can make better choices and protect your 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.
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