Skip to main content
Top
Published in: Digestive Diseases and Sciences 7/2019

Open Access 01-07-2019 | Original Article

Risk Behaviors Associated with Alcohol Consumption Predict Future Severe Liver Disease

Authors: Hannes Hagström, Tomas Hemmingsson, Andrea Discacciati, Anna Andreasson

Published in: Digestive Diseases and Sciences | Issue 7/2019

Login to get access

Abstract

Background

Excess consumption of alcohol can lead to cirrhosis, but it is unclear whether the type of alcohol and pattern of consumption affects this risk.

Aims

We aimed to investigate whether type and pattern of alcohol consumption early in life could predict development of severe liver disease.

Methods

We examined 43,242 adolescent men conscribed to military service in Sweden in 1970. Self-reported data on total amount and type of alcohol (wine, beer, and spirits) and risk behaviors associated with heavy drinking were registered. Population-based registers were used to ascertain incident cases of severe liver disease (defined as cirrhosis, decompensated liver disease, liver failure, hepatocellular carcinoma, or liver-related mortality). Cox regression models were used to estimate hazard ratios for development of severe liver disease.

Results

During follow-up, 392 men developed severe liver disease. In multivariable analysis, after adjustment for BMI, smoking, use of narcotics, cardiovascular fitness, cognitive ability, and total amount of alcohol, an increased risk for severe liver disease was found in men who reported drinking alcohol to alleviate a hangover (“eye-opener”; aHR 1.47, 95% CI 1.02–2.11) and men who reported having been apprehended for being drunk (aHR 2.17, 95% CI 1.63–2.90), but not for any other risk behaviors. Wine consumption was not associated with a reduced risk for severe liver disease compared to beer and spirits.

Conclusions

Certain risk behaviors can identify young men with a high risk of developing severe liver disease. Wine consumption was not associated with a reduced risk for severe liver disease compared to beer and spirits.
Appendix
Available only for authorised users
Literature
1.
go back to reference Sorensen TI, Orholm M, Bentsen KD, Hoybye G, Eghoje K, Christoffersen P. Prospective evaluation of alcohol abuse and alcoholic liver injury in men as predictors of development of cirrhosis. Lancet. 1984;2:241–244.CrossRefPubMed Sorensen TI, Orholm M, Bentsen KD, Hoybye G, Eghoje K, Christoffersen P. Prospective evaluation of alcohol abuse and alcoholic liver injury in men as predictors of development of cirrhosis. Lancet. 1984;2:241–244.CrossRefPubMed
2.
go back to reference Lieber CS, Jones DP, Decarli LM. Effects of prolonged ethanol intake: production of fatty liver despite adequate diets. J Clin Invest. 1965;44:1009–1021.CrossRefPubMedPubMedCentral Lieber CS, Jones DP, Decarli LM. Effects of prolonged ethanol intake: production of fatty liver despite adequate diets. J Clin Invest. 1965;44:1009–1021.CrossRefPubMedPubMedCentral
3.
go back to reference Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual causes of death in the United States, 2000. JAMA. 2004;291:1238–1245.CrossRefPubMed Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual causes of death in the United States, 2000. JAMA. 2004;291:1238–1245.CrossRefPubMed
5.
go back to reference Rehm J, Taylor B, Mohapatra S, et al. Alcohol as a risk factor for liver cirrhosis: a systematic review and meta-analysis. Drug Alcohol Rev. 2010;29:437–445.CrossRefPubMed Rehm J, Taylor B, Mohapatra S, et al. Alcohol as a risk factor for liver cirrhosis: a systematic review and meta-analysis. Drug Alcohol Rev. 2010;29:437–445.CrossRefPubMed
6.
go back to reference Hagstrom H, Hemmingsson T, Discacciati A, Andreasson A. Alcohol consumption in late adolescence is associated with an increased risk of severe liver disease later in life. J Hepatol. 2018;68:505–510.CrossRefPubMed Hagstrom H, Hemmingsson T, Discacciati A, Andreasson A. Alcohol consumption in late adolescence is associated with an increased risk of severe liver disease later in life. J Hepatol. 2018;68:505–510.CrossRefPubMed
7.
go back to reference Tian C, Stokowski RP, Kershenobich D, Ballinger DG, Hinds DA. Variant in PNPLA3 is associated with alcoholic liver disease. Nat Genet. 2010;42:21–23.CrossRefPubMed Tian C, Stokowski RP, Kershenobich D, Ballinger DG, Hinds DA. Variant in PNPLA3 is associated with alcoholic liver disease. Nat Genet. 2010;42:21–23.CrossRefPubMed
8.
go back to reference Askgaard G, Gronbaek M, Kjaer MS, Tjonneland A, Tolstrup JS. Alcohol drinking pattern and risk of alcoholic liver cirrhosis: a prospective cohort study. J Hepatol. 2015;62:1061–1067.CrossRefPubMed Askgaard G, Gronbaek M, Kjaer MS, Tjonneland A, Tolstrup JS. Alcohol drinking pattern and risk of alcoholic liver cirrhosis: a prospective cohort study. J Hepatol. 2015;62:1061–1067.CrossRefPubMed
9.
go back to reference Becker U, Gronbaek M, Johansen D, Sorensen TI. Lower risk for alcohol-induced cirrhosis in wine drinkers. Hepatology. 2002;35:868–875.CrossRefPubMed Becker U, Gronbaek M, Johansen D, Sorensen TI. Lower risk for alcohol-induced cirrhosis in wine drinkers. Hepatology. 2002;35:868–875.CrossRefPubMed
10.
go back to reference Tuyns AJ, Esteve J, Pequignot G. Ethanol is cirrhogenic, whatever the beverage. Br J Addict. 1984;79:389–393.CrossRefPubMed Tuyns AJ, Esteve J, Pequignot G. Ethanol is cirrhogenic, whatever the beverage. Br J Addict. 1984;79:389–393.CrossRefPubMed
11.
go back to reference Pelletier S, Vaucher E, Aider R, et al. Wine consumption is not associated with a decreased risk of alcoholic cirrhosis in heavy drinkers. Alcohol Alcohol (Oxf, Oxfords). 2002;37:618–621.CrossRef Pelletier S, Vaucher E, Aider R, et al. Wine consumption is not associated with a decreased risk of alcoholic cirrhosis in heavy drinkers. Alcohol Alcohol (Oxf, Oxfords). 2002;37:618–621.CrossRef
12.
go back to reference Kamper-Jorgensen M, Gronbaek M, Tolstrup J, Becker U. Alcohol and cirrhosis: dose–response or threshold effect? J Hepatol. 2004;41:25–30.CrossRefPubMed Kamper-Jorgensen M, Gronbaek M, Tolstrup J, Becker U. Alcohol and cirrhosis: dose–response or threshold effect? J Hepatol. 2004;41:25–30.CrossRefPubMed
14.
go back to reference Aberg F, Helenius-Hietala J, Puukka P, Jula A. Binge drinking and the risk of liver events: a population-based cohort study. Liver Int. 2017;37:1373–1381.CrossRefPubMed Aberg F, Helenius-Hietala J, Puukka P, Jula A. Binge drinking and the risk of liver events: a population-based cohort study. Liver Int. 2017;37:1373–1381.CrossRefPubMed
15.
go back to reference Mathurin P, Deltenre P. Effect of binge drinking on the liver: an alarming public health issue? Gut. 2009;58:613–617.CrossRefPubMed Mathurin P, Deltenre P. Effect of binge drinking on the liver: an alarming public health issue? Gut. 2009;58:613–617.CrossRefPubMed
16.
go back to reference Louvet A, Krag A. Managing excessive alcohol consumption at a population level: the earlier the better. J Hepatol. 2018;68:389–390.CrossRefPubMed Louvet A, Krag A. Managing excessive alcohol consumption at a population level: the earlier the better. J Hepatol. 2018;68:389–390.CrossRefPubMed
17.
go back to reference O’shea RS, Dasarathy S, Mccullough AJ. Alcoholic liver disease. Am J Gastroenterol. 2010;105:14–32.CrossRefPubMed O’shea RS, Dasarathy S, Mccullough AJ. Alcoholic liver disease. Am J Gastroenterol. 2010;105:14–32.CrossRefPubMed
18.
go back to reference European Association for the Study of Liver. EASL clinical practical guidelines: management of alcoholic liver disease. J Hepatol. 2012;57:399–420.CrossRef European Association for the Study of Liver. EASL clinical practical guidelines: management of alcoholic liver disease. J Hepatol. 2012;57:399–420.CrossRef
19.
go back to reference Sjolund S, Hemmingsson T, Allebeck P. IQ and level of alcohol consumption—findings from a national survey of Swedish conscripts. Alcohol Clin Exp Res. 2015;39:548–555.CrossRefPubMedPubMedCentral Sjolund S, Hemmingsson T, Allebeck P. IQ and level of alcohol consumption—findings from a national survey of Swedish conscripts. Alcohol Clin Exp Res. 2015;39:548–555.CrossRefPubMedPubMedCentral
20.
go back to reference Hemmingsson T, Melin B, Allebeck P, Lundberg I. Cognitive ability in adolescence and mortality in middle age: a prospective life course study. J Epidemiol Community Health. 2009;63:697–702.CrossRefPubMed Hemmingsson T, Melin B, Allebeck P, Lundberg I. Cognitive ability in adolescence and mortality in middle age: a prospective life course study. J Epidemiol Community Health. 2009;63:697–702.CrossRefPubMed
21.
go back to reference Hemmingsson T, Melin B, Allebeck P, Lundberg I. The association between cognitive ability measured at ages 18–20 and mortality during 30 years of follow-up—a prospective observational study among Swedish males born 1949–51. Int J Epidemiol. 2006;35:665–670.CrossRefPubMed Hemmingsson T, Melin B, Allebeck P, Lundberg I. The association between cognitive ability measured at ages 18–20 and mortality during 30 years of follow-up—a prospective observational study among Swedish males born 1949–51. Int J Epidemiol. 2006;35:665–670.CrossRefPubMed
22.
go back to reference Ludvigsson JF, Otterblad-Olausson P, Pettersson BU, Ekbom A. The Swedish personal identity number: possibilities and pitfalls in healthcare and medical research. Eur J Epidemiol. 2009;24:659–667.CrossRefPubMedPubMedCentral Ludvigsson JF, Otterblad-Olausson P, Pettersson BU, Ekbom A. The Swedish personal identity number: possibilities and pitfalls in healthcare and medical research. Eur J Epidemiol. 2009;24:659–667.CrossRefPubMedPubMedCentral
23.
24.
go back to reference Royston P, Sauerbrei W, Becher H. Modelling continuous exposures with a ‘spike’ at zero: a new procedure based on fractional polynomials. Stat Med. 2010;29:1219–1227.CrossRefPubMed Royston P, Sauerbrei W, Becher H. Modelling continuous exposures with a ‘spike’ at zero: a new procedure based on fractional polynomials. Stat Med. 2010;29:1219–1227.CrossRefPubMed
26.
go back to reference Hatton J, Burton A, Nash H, Munn E, Burgoyne L, Sheron N. Drinking patterns, dependency and life-time drinking history in alcohol-related liver disease. Addiction. 2009;104:587–592.CrossRefPubMed Hatton J, Burton A, Nash H, Munn E, Burgoyne L, Sheron N. Drinking patterns, dependency and life-time drinking history in alcohol-related liver disease. Addiction. 2009;104:587–592.CrossRefPubMed
27.
go back to reference Mccarty CA, Ebel BE, Garrison MM, Digiuseppe DL, Christakis DA, Rivara FP. Continuity of binge and harmful drinking from late adolescence to early adulthood. Pediatrics. 2004;114:714–719.CrossRefPubMed Mccarty CA, Ebel BE, Garrison MM, Digiuseppe DL, Christakis DA, Rivara FP. Continuity of binge and harmful drinking from late adolescence to early adulthood. Pediatrics. 2004;114:714–719.CrossRefPubMed
28.
go back to reference Merline A, Jager J, Schulenberg JE. Adolescent risk factors for adult alcohol use and abuse: stability and change of predictive value across early and middle adulthood. Addiction. 2008;103:84–99.CrossRefPubMedPubMedCentral Merline A, Jager J, Schulenberg JE. Adolescent risk factors for adult alcohol use and abuse: stability and change of predictive value across early and middle adulthood. Addiction. 2008;103:84–99.CrossRefPubMedPubMedCentral
29.
go back to reference Kneeman JM, Misdraji J, Corey KE. Secondary causes of nonalcoholic fatty liver disease. Ther Adv Gastroenterol. 2012;5:199–207.CrossRef Kneeman JM, Misdraji J, Corey KE. Secondary causes of nonalcoholic fatty liver disease. Ther Adv Gastroenterol. 2012;5:199–207.CrossRef
30.
31.
go back to reference Jensen MK, Andersen AT, Sorensen TI, Becker U, Thorsen T, Gronbaek M. Alcoholic beverage preference and risk of becoming a heavy drinker. Epidemiology (Cambridge, Mass). 2002;13:127–132.CrossRef Jensen MK, Andersen AT, Sorensen TI, Becker U, Thorsen T, Gronbaek M. Alcoholic beverage preference and risk of becoming a heavy drinker. Epidemiology (Cambridge, Mass). 2002;13:127–132.CrossRef
32.
go back to reference Singh S, Allen AM, Wang Z, Prokop LJ, Murad MH, Loomba R. Fibrosis progression in nonalcoholic fatty liver vs nonalcoholic steatohepatitis: a systematic review and meta-analysis of paired-biopsy studies. Clin Gastroenterol Hepatol. 2015;13:643–654. (e641-649; quiz e639-640).CrossRefPubMed Singh S, Allen AM, Wang Z, Prokop LJ, Murad MH, Loomba R. Fibrosis progression in nonalcoholic fatty liver vs nonalcoholic steatohepatitis: a systematic review and meta-analysis of paired-biopsy studies. Clin Gastroenterol Hepatol. 2015;13:643–654. (e641-649; quiz e639-640).CrossRefPubMed
33.
go back to reference Schwartz JM, Reinus JF. Prevalence and natural history of alcoholic liver disease. Clin Liver Dis. 2012;16:659–666.CrossRefPubMed Schwartz JM, Reinus JF. Prevalence and natural history of alcoholic liver disease. Clin Liver Dis. 2012;16:659–666.CrossRefPubMed
34.
go back to reference Poynard T, Bedossa P, Opolon P. Natural history of liver fibrosis progression in patients with chronic hepatitis C. Lancet. 1997;349:825–832.CrossRefPubMed Poynard T, Bedossa P, Opolon P. Natural history of liver fibrosis progression in patients with chronic hepatitis C. Lancet. 1997;349:825–832.CrossRefPubMed
Metadata
Title
Risk Behaviors Associated with Alcohol Consumption Predict Future Severe Liver Disease
Authors
Hannes Hagström
Tomas Hemmingsson
Andrea Discacciati
Anna Andreasson
Publication date
01-07-2019
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 7/2019
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-019-05509-6

Other articles of this Issue 7/2019

Digestive Diseases and Sciences 7/2019 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.