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Daily alcohol intake increased risk for alcoholic cirrhosis in men

Men who drank alcohol on a daily basis had an increased risk for alcoholic cirrhosis, according to a recent study published in the Journal of Hepatology.

“Implications of our study for public health and clinical counseling are that there seems to be some gain when cutting down on alcohol amount, regardless of the high level of lifetime alcohol consumption, and that daily drinkers should be advised to drink less frequently,” researcher Gro Askgaard, MD, of the department of hepatology at Copenhagen University Hospital, Rigshospitalet, and the National Institute of Public Health, University of Southern Denmark in Copenhagen, told Healio.com/Hepatology.

Gro Askgaard

Askgaard and colleagues used information on alcohol intake, drinking pattern and confounders from questionnaires obtained in 1993-1997 from 55,917 participants in the Danish Cancer, Diet and Health Study to investigate the risk for alcoholic cirrhosis according to drinking pattern. Of all the participants, 257 men and 85 women developed alcoholic cirrhosis, resulting in an incident rate of alcoholic cirrhosis of 66 in men and 19 in women per 100,000 person-years, according to the research. Median follow-up was 14.9 years.

The median alcohol amount for men was 8.9 drinks per week (2 to 4 days per week) and 26 drinks in daily drinkers. Among the women, the median alcohol amount was 6.6 drinks per week and 19 drinks in daily drinkers, according to the research.

Men who drank between 14 and 28 drinks per week had an HR of 2.33 (95% CI, 1.52-3.58) compared with 3.49 (95% CI, 2.00-6.12) for women. The men also had an HR of 6.98 (95% CI, 4.65-10.5) for consuming 28 to 42 drinks per week compared with women who had an HR of 16.2 (95% CI, 9.16-28.7). After adjusting for age and other variables, the highest number of alcoholic cirrhosis cases was found in daily drinkers (171 in men, 30 in women).

Alcohol amount in recent age periods (40–49 and 50–59 years) was associated with an increased risk, whereas the amount in 20–29 and 30–39 years was not and the authors concluded that recent alcohol consumption rather than earlier in life was associated with risk of alcoholic cirrhosis.

Men who drank between 14 and 28 drinks per week had an HR of 2.33 (95% CI, 1.52-3.58) compared with 3.49 (95% CI, 2.00-6.12) for women. The men also had an HR of 6.98 (95% CI, 4.65-10.5) for consuming 28 to 42 drinks per week compared with women who had an HR of 16.2 (95% CI, 9.16-28.7). After adjusting for age and other variables, the highest number of alcoholic cirrhosis cases was found in daily drinkers (171 in men, 30 in women).

Researchers found that men had a decreased risk for alcoholic cirrhosis when aged 20 to 29 years and 30 to 39 years vs. 40 to 49 years and 50 to 59 years, indicating that the risk for alcoholic cirrhosis increased as they got older. For the women, only those aged 40 to 49 years showed signs of increased risk for alcoholic cirrhosis.

Men who drank 14 to 28 drinks per week consisting mostly of wine (≥50%) had a lower HR (1.69; 95% CI, 0.79-3.65) compared with men who drank less than 1% of wine (7.47; 95% CI, 1.68-33.12) or between 1% and 15% of wine (3.12; 95% CI, 1.53-6.39).

There was no risk for alcoholic cirrhosis among participants who were lifetime abstainers of alcohol.

“This study confirmed the dose-response relationship between alcohol amount and alcoholic cirrhosis,” Askgaard said. “Among men, the risk of alcoholic cirrhosis was higher in daily drinkers compared to less frequent drinkers (for instance drinkers of 5-6 days/week), when alcohol amount was taken into account. Furthermore, our results suggested that recent alcohol consumption, and not lifetime alcohol consumption, is the strongest predictor of alcoholic cirrhosis.”

Askgaard added: “Regarding beverage type, wine was associated with a lower risk of alcoholic cirrhosis compared to beer and liquor, for the same level of alcohol amount. Among women, we are unable to draw firm conclusions due to low statistical power, though, in general, we found the same trends.” – by Melinda Stevens

Disclosure: The researchers report no relevant financial disclosures.