Alcohol consumption and the risk of alcohol related cirrhosis in women.

Norton, Robyn; Batey, Robert; Dwyer, Terry; MacMahon, Stephen

doi:10.1136/bmj.295.6590.80

Cited by 136 publications

(38 citation statements)

References 10 publications

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“…The amount of alcohol consumption causing adverse effects on the liver is controversial (23)(24)(25). In the Dionysos study it was reported that the threshold for ALD was ingestion of >30g alcohol per day in both sexes (24).…”

Section: Discussionmentioning

confidence: 99%

Effects of moderate red wine consumption on liver fat and blood lipids: a prospective randomized study

Kechagias¹,

Zanjani²,

Gjellan³

et al. 2011

Annals of Medicine

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Methods: Thirty-two healthy women and 12 healthy men (34±9 years of age) were randomized to consume 150 ml of red wine/day for women (16g ethanol/d) or the double amount for men (33g ethanol/d), or to alcohol abstention during 90 days.Participants underwent proton-nuclear magnetic-resonance spectroscopy for measurement of hepatic triglyceride content (HTGC). Blood samples for assessment of cardiovascular risk were drawn before and after the intervention.Results: After exclusion of three subjects with steatosis at baseline a trend towards increased HTGC was apparent by red wine (before median: 1.1%, range 0.2-3.9%, after median: 1.1%, range 0.5-5.2 %, p=0.059) a difference that was statistically significant compared with abstainers (p=0.02). However, no subject developed hepatic steatosis.LDL-cholesterol was lowered by red wine (-0.3 mmol/l, SE -0.1, 95% CI -0.6 to -0.04). Conclusions:Moderate consumption of red wine during three months increased HTGC in subjects without steatosis at baseline. However, since not a single participant developed steatosis we suggest that the threshold of alcohol consumption to define nonalcoholic fatty liver disease should not be lower than the amount in our study.  The results of this study provide original information about the effect of moderate wine drinking on the hepatic triglyceride content.

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Section: Discussionmentioning

confidence: 99%

Effects of moderate red wine consumption on liver fat and blood lipids: a prospective randomized study

Kechagias¹,

Zanjani²,

Gjellan³

et al. 2011

Annals of Medicine

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“…58 Many casecontrol studies and case series of patients with liver disease or alcohol dependence have also suggested increased sensitivity of women to the deleterious effects of alcohol on the liver. 30,[114][115][116][117][118][119][120] Postmenopausal women with cirrhosis have elevated estrogen and decreased testosterone levels that appear to correlate with the severity of liver disease. 121 One casecontrol study suggested that reproductive hormone levels may have prognostic value for women with end-stage alcohol-related liver disease.…”

Section: Medical Risks Of Drinking For Women Compared With Menmentioning

confidence: 99%

Medical risks for women who drink alcohol

et al. 1998

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OBJECTIVE:To summarize for clinicians recent epidemiologic evidence regarding medical risks of alcohol use for women.METHODS: MEDLINE and PsychINFO, 1990 through 1996, were searched using key words "women" or "woman," and "alcohol." MEDLINE was also searched for other specific topics and authors from 1980 through 1996. Data were extracted and reviewed regarding levels of alcohol consumption associated with mortality, cardiovascular disease, alcoholrelated liver disease, injury, osteoporosis, neurologic symptoms, psychiatric comorbidity, fetal alcohol syndrome, spontaneous abortion, infertility, menstrual symptoms, breast cancer, and gynecologic malignancies. Gender-specific data from cohort studies of general population or large clinical samples are primarily reviewed. MAIN RESULTS:Women develop many alcohol-related medical problems at lower levels of consumption than men, probably reflecting women's lower total body water, gender differences in alcohol metabolism, and effects of alcohol on postmenopausal estrogen levels. Mortality and breast cancer are increased in women who report drinking more than two drinks daily. Higher levels of alcohol consumption by women are associated with increased menstrual symptoms, hypertension, and stroke. Women who drink heavily also appear to have increased infertility and spontaneous abortion. Adverse fetal effects occur after variable amounts of alcohol consumption, making any alcohol use during pregnancy potentially harmful. CONCLUSIONS:In general, advising nonpregnant women who drink alcohol to have fewer than two drinks daily is strongly supported by the epidemiologic literature, although specific recommendations for a particular woman should depend on her medical history and risk factors. L ess than three quarters of women in the UnitedStates drink alcohol, and those who do drink consume fewer drinks and less absolute alcohol than men. 1 However, at similar levels of self-reported alcohol consumption, the risk of psychosocial problems or dependence is greater for women than men (for definitions, see Appendix A). [2][3][4][5][6] Women also appear to develop alcohol abuse and dependence after fewer years of drinking than men. 7 Although only 4% to 5% of women in the U.S. general population meet criteria for past-year alcohol abuse or dependence, 8,9 9% of female primary care patients in some studies have reported recent heavy drinking or alcohol-related problems. 10,11 Many heavy drinkers decrease consumption following brief interventions that include explicit advice about safe drinking limits. [12][13][14] In addition, offering feedback about specific risks or consequences of their drinking to patients who drink heavily can help motivate them to decrease alcohol consumption or seek treatment. 15,16 Physicians report they would be more likely to advise patients about safe drinking practices if they were more confident of their knowledge about safe levels of alcohol consumption. 17 Women who drink more than two drinks daily on average, or who frequently drink five or more d...

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“…[3][4][5]8,9 These studies are difficult to A bias of the relative risk function could have been interpret. First, the possible and likely effect of alcohol introduced because some participants may have had intake on risk of hospitalization per se among patients alcohol-induced liver disease or alcohol-induced cirrho-with alcohol-induced liver disease may confound the sis before entry into the study.…”

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confidence: 99%

Prediction of risk of liver disease by alcohol intake, sex, and age: A prospective population study

et al. 1996

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The association between self-reported alcohol intake spective assessment of alcohol intake at the time of and the risk of future liver disease was studied in a large diagnosis of liver damage, it has been observed that population-based prospective cohort with 12-year fol-the risk of developing liver damage increased by the low-up. Alcohol intake was assessed in 13,285 men and amount consumed, and the minimum alcohol intake women aged 30 to 79 years by a self-administered ques-associated with a significant increase in risk ranged tionnaire. Diagnoses indicating alcohol-induced liver from 40 to 80 g daily in most studies, 3-9 but for methoddisease (n Å 261) or alcohol-induced cirrhosis (n Å 124) ological reasons the interpretation of these studies is were obtained from death certificates and the hospital difficult. 1 A prospective study based on an American discharge register, and data were analyzed by multiplihealth care program confirmed the dose-dependent ascative Poisson regression models. The total cumulated sociation, but both alcohol intake and occurrence of observation time was 130,558 person-years. The overall incidence rates of alcohol-induced cirrhosis were 0.2% liver disease may have been considerably underreper year in men and 0.03% per year in women. The nadir ported. 10 In another prospective study, heavy drinkers of the estimated relative risk of developing liver disease showed no further increase in risk of developing cirrhowas observed at an alcohol intake of 1 to 6 beverages sis by increasing alcohol intake. 11 per week, and above this level a steep increase in relaSeveral studies have shown that women have more tive risk was observed. The risk function was indepen-advanced liver disease at time of diagnosis, run a more dent of age and stable over time. The level of alcohol severe course of the disease, and report a shorter hisintake above which the relative risk was significantly tory of alcohol abuse and a smaller intake of alcohol greater than 1 was observed at 7 to 13 beverages per than men. 5,[12][13][14][15][16][17][18][19] This has been taken as evidence for week for women and 14 to 27 beverages per week for women being more prone to develop alcohol-induced men. Women had a significantly higher relative risk of developing alcohol-related liver disease than men for liver disease than men. If we assume that men and any given level of alcohol intake. We observed a dose-women have the same threshold for development of dependent increase in relative risk of developing alco-liver damage and that women drink less than men, hol-induced liver disease for both men and women, with then those women who develop alcohol-induced liver the steepest increase among women. In the general pop-disease would on average have a lower alcohol intake ulation, self-reported current alcohol intake is a good than men with alcohol-induced liver disease. To estipredictor of the future risk of alcohol-induced liver dis-mate the risk at the individual level, the distribution ease. (HEPATOLOGY 1996;23:1025-1029 of alcoho...

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Alcohol consumption and the risk of alcohol related cirrhosis in women.

Cited by 136 publications

References 10 publications

Effects of moderate red wine consumption on liver fat and blood lipids: a prospective randomized study

Effects of moderate red wine consumption on liver fat and blood lipids: a prospective randomized study

Medical risks for women who drink alcohol

Prediction of risk of liver disease by alcohol intake, sex, and age: A prospective population study

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