Alcohol consumption and the risk of liver disease: a nationwide, population-based study

Sang Yi Moon; Minkook Son; Yeo Wool Kang; Myeongseok Koh; Jong Yoon Lee; Yang Hyun Baek

doi:10.3389/fmed.2023.1290266

Alcohol consumption and the risk of liver disease: a nationwide, population-based study

Front Med (Lausanne). 2023 Nov 28:10:1290266. doi: 10.3389/fmed.2023.1290266. eCollection 2023.

Authors

Sang Yi Moon¹, Minkook Son², Yeo Wool Kang¹, Myeongseok Koh¹, Jong Yoon Lee¹, Yang Hyun Baek¹

Affiliations

¹ Division of Gastroenterology, Department of Internal Medicine, Dong-A University College of Medicine, Busan, Republic of Korea.
² Department of Physiology, Dong-A University College of Medicine, Busan, Republic of Korea.

Abstract

Introduction: Although most patients with alcohol-related liver disease (ALD) have a history of prolonged and heavy drinking, there is no clear threshold defining the level of alcohol consumption that leads to ALD. We aimed to evaluate the correlation between average alcohol consumption and the risk of liver disease and to determine the threshold for clinically significant alcohol consumption.

Materials and methods: Using the Korean National Health Insurance database, we identified participants who underwent a health-screening program in 2010 and 2011 and retrospectively analyzed their data until 2019. To diagnose and categorize the extracted participants, we used the International Classification of Diseases version 10 and Fatty Liver Index. The primary outcome was to determine the incidence of newly diagnosed liver-related diseases during the observation period and compare the incidence of liver-related diseases among non-drinkers and drinkers based on the amount of alcohol consumption.

Results: A total of 53,006 patients were enrolled and followed-up for a median of 8.4 years, during which 1,509 cases of liver-related diseases occurred. The participants were divided into five groups: no alcohol consumption (n = 31,359), 1st quartile (n = 5,242), 2nd quartile (n = 5,704), 3rd quartile (n = 5,337), and 4th quartile (n = 5,364). The corresponding number of glasses of alcohol consumed per week for each quantile (Q1, Q2, Q3, and Q4) was labeled 2.5 ± 1.1 standard units (1 standard unit = 8 g alcohol), 5.4 ± 1.9 standard units, 11.5 ± 3.3 standard units, and 27.9 ± 18.2 standard units, respectively. Compared with non-drinkers, the risk of liver-related disease was found to be higher in Q1 drinkers (adjusted hazard ratio [aHR], 1.09; 95% CI, 0.90-1.33), Q2 drinkers (aHR, 1. 10; 95% CI, 0.91-1.32), Q3 drinkers (aHR, 1.33; 95% CI, 1.11-1.59), and Q4 drinkers (aHR, 1.47; 95% CI, 1.24-1.75).

Conclusion: We report that our study has shown that drinking more than 11.5 ± 3.3 standard units/week (92 ± 26.4 g/week) significantly increases the risk of developing liver-related diseases. Therefore, as a preventive measure to reduce the risk of developing liver disease, alcohol consumption should be limited beyond traditionally recommended levels.

Keywords: alcohol; alcoholic liver disease; chronic hepatitis; liver cirrhosis; nation-wide population-based study.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was funded by Dong-A University.