Drink the same person, but the harm is worse

According to an explanation Clinical gastroenterology and hepatology Research from Keck Medicine at the University of Southern California. The study tracked a nationally representative sample of adults in the United States from 1999 to 2020 and found that the growth of liver scars (called fibrosis) increased dramatically, even if their drinking levels did not change.

“Alcohol-related liver disease is the main cause of liver death, and these results are the main appeal for the danger of drinking,” said Brian P. Lee, a hepatologist at Keck Medicine, Brian P. Lee, MD, MAS, and Brian P. Lee, MD, senior author of the study.

Despite drinking alcohol intake, the risk has increased by twofold

The researchers analyzed data from more than 44,000 adults aged 20 and over, highlighting 2,474 people who met the “increase alcohol consumption” standard. The threshold – 20 grams of alcohol per day for women and 30 grams of men – about 1.5 and 2 standard drinks per day.

Key findings include:

• The rate of significant liver fibrosis in weight drinkers increased from 1.8% in the early 2000s to 4.3% in 2020, more than tripled.
• In the age group of 35-65 years, the prevalence of fibrosis among weight drinkers jumped from 2.8% to 5.8%, which is actually tripled between 1999 and 2018.
• By contrast, fibrosis increased from 0.8% to 1.4% in people who did not drink a lot of alcohol during the same period.

Importantly, the average alcohol consumption of these heavy drinkers remained at about 50 grams per day throughout the study period. So, what will aggravate the losses?

Change the health of drinkers

It turns out that people who drink large amounts of drinks may be important as people who drink water. According to the study, the demographics of the heaviest drinkers in the United States have changed over the past 20 years:

• Weight drinkers are now older on average.
• Women, low-income individuals and metabolic syndrome have increased.

Metabolic Syndrome – A range of risk factors, including hypertension, abdominal obesity and elevated blood sugar, increased by more than 40% in heavy drinkers. These potential conditions can interact with alcohol to accelerate liver damage.

“Our results show that there has been a change in the composition of the American public who consumed heavily compared to 20 years ago,” Lee said. “This could explain the increase in liver disease.”

Which clinicians should know

The study used a noninvasive liver fibrosis score called FIB-4, which predicts liver-related death. The researchers excluded patients with hepatitis C or C to isolate the effects of alcohol and metabolic factors. Even if age, gender, BMI and poverty status are taken into account, the upward trend of liver disease remains.

Lee hopes that these findings will stimulate targeted screening and intervene earlier in patients at risk, especially in heavy drinking and metabolic risk factors.

The study, based on previous work by Lee and colleagues, shows that alcohol-related liver disease has surged during the COVID-19 pandemic and that people with diabetes or increased waist circumference are particularly vulnerable.

Magazine: Clinical gastroenterology and hepatology
doi: 10.1016/j.cgh.2025.07.006

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