Alcohol remains the second most common cause of liver cirrhosis after hepatitis C virus (HCV) infection in the United States, contributing to approximately 20% to 25% cases of liver cirrhosis and about half of all admissions among patients with cirrhosis. Of the various factors responsible for liver disease, duration and amount of drinking alcohol is the most important factor.
Pooled data from many epidemiological studies show a minimum intake of 30g/day of alcohol in women and 50g/day in men consumed over at least 5 years to cause liver cirrhosis. Prevalence and mortality rates from cirrhosis parallel alcohol consumption prevalence rates in the population globally.
Within Europe, which has the highest rate of consumption per capita in the implementation of policies on alcohol sale has resulted in changing epidemiology in different parts of Europe. Alcohol consumption rates have decreased in southern Europe, whereas they have increased in eastern Europe and some areas of northern Europe (including Ireland and the United Kingdom, although now in decline again since 2005).
Because only 10% to 15% of people engaged in heavy drinking develop liver cirrhosis, other factors such as host factors and comorbidities are clearly important). Women are more prone to the hepatotoxic effect of alcohol compared with men and are prone to develop liver cirrhosis at a lower amount of alcohol consumption.
Type of alcohol consumed, binge drinking (five or more drinks at one time), drinking on an empty stomach, alcohol use and concomitant HCV infection act synergistically to cause more frequent and faster progression of fibrosis. With the epidemic of obesity in the United States, prevalence rates of metabolic syndrome and visceral adiposity are increasing among alcoholics contributing to more prevalent and severe liver disease.
Source: Recent trends in the epidemiology of alcoholic liver disease. Ashwani K. Singal MD, MS, Bhupinderjit S. Anand M.D., Ph.D. Clinical Liver Disease