Single night alcohol binge more likely to cause liver disease than few drinks a week, says study

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People who binge drink are three times more likely to develop liver disease compared to people who drink a few times a week, according to new research.

Scientists from UCL, the Royal Free Hospital, the University of Oxford and the University of Cambridge found that the patterns of drinking are more important than volume for predicting the risk of developing alcohol-related cirrhosis (ARC).

Liver disease is one of the major causes of premature death globally, with 2 to 3 per cent of the world’s population having cirrhosis (scarring of the liver) or liver disease. Since the Covid-19 pandemic began, alcohol-related deaths have risen by 20%.

For this study, researchers analysed data from 312,599 actively drinking adults in the UK Biobank, to find the impacts of drinking patterns, genetic predisposition and type-2 diabetes on the likelihood of developing ARC.

People who engaged in heavy binge drinking - defined as having 12 units in a day at some point during a week - were three times as likely to develop ARC. The risk for those with a high genetic predisposition was four times higher and the risk for type-2 diabetics was two times higher.

When heavy binge drinking and high genetic predisposition taken into account, the risk of developing ARC was six times higher than the baseline risk. The further addition of type-2 diabetes resulted in an even greater risk.

Although the methods used in this study (polygenic risk scores) are not in widespread clinical use at the moment, they are likely to become more common as a method of defining personalised disease risk.

Pamela Healy, chief executive of the British Liver Trust said: “This research is important because it reveals that it’s not just how much you drink overall but the way that you drink matters. Drinking a lot, quickly, or drinking to get drunk can have serious consequences for your liver health.

“Over the last twenty years, as alcohol has become more accessible and affordable, there has been a disconcerting shift in the UK’s drinking culture. The UK needs to tackle increased alcohol consumption through a joined-up ‘alcohol strategy’ that includes taxation, stronger controls on alcohol advertising and marketing and improved awareness of the dangers of binge drinking.”

Dr Linda Ng Fat, one of the authors of the study from UCL Epidemiology & Public Health, said: “Many studies that look into the relationship between liver disease and alcohol focus on the volume of alcohol consumed. We took a different approach by focusing on the pattern of drinking and found that this was a better indicator of liver disease risk than volume alone. The other key finding was that the more risk factors involved, the higher the ‘excess risk’ due to the interaction of these factors.”

Dr Gautam Mehta, from UCL Division of Medicine and the Royal Free Hospital, said: “Only one in three people who drink at high levels go on to develop serious liver disease. While genetics plays a part, this research highlights that pattern of drinking is also a key factor. Our results suggest, for example, that it would be more damaging to drink 21 units over a couple of sessions rather than spread evenly over a week. Adding genetic information, which may be widely used in healthcare over the coming years, allows an even more accurate prediction of risk.”