In a groundbreaking study published in “Nature Communications,” researchers led by Gautam Mehta have highlighted a worrying trend: a sharp rise in alcohol-related liver disease (ARLD) following the Covid-19 pandemic.
This increase is particularly notable in the UK, where ARLD deaths have surged by about 20%, and similar patterns are observed in the USA and Asia. Intriguingly, this rise has occurred without a corresponding increase in overall alcohol consumption at the population level.Â
The study zeroes in on binge-pattern alcohol consumption as a significant risk factor for ARLD. Binge drinking, characterized by heavy episodic alcohol intake, has been linked to an elevated risk of developing alcohol-related cirrhosis (ARC) and alcoholic hepatitis (AH). This association holds even when accounting for total weekly alcohol intake and other demographic and lifestyle factors. The findings suggest that the pattern of alcohol consumption, rather than just the quantity, plays a crucial role in liver disease risk.Â
Another pivotal aspect of the study is the role of genetic susceptibility in ARLD. Utilizing a polygenic risk score (PRS) to gauge genetic risk, the researchers found a clear correlation: higher PRS scores were associated with an increased risk of ARC. This relationship was consistent even after adjusting for binge drinking patterns and other factors like diabetes mellitus and obesity.Â
Diabetes mellitus emerges as another key factor in the study. It significantly increases the risk of ARC across all alcohol consumption groups and PRS categories. Notably, the study found significant additive interactions between diabetes and heavy binge drinking, as well as between diabetes and high genetic risk, in influencing ARC risk.Â
These findings were validated in the China Kadoorie Biobank (CKB), reinforcing the interactions between binge-pattern drinking and diabetes mellitus. The study’s implications are far-reaching, suggesting that interventions for ARLD should not only focus on reducing alcohol consumption but also consider individual genetic risks and the presence of conditions like diabetes.Â
The study by Mehta and colleagues is a clarion call for public health strategies that consider the complex interplay of behavioral patterns, genetic predispositions, and metabolic conditions in tackling ARLD.
It underscores the need for targeted interventions and screening strategies, especially for individuals at high risk due to their drinking patterns, genetic makeup, and metabolic health. As the world grapples with the aftermath of the Covid-19 pandemic, addressing the rising tide of alcohol-related liver diseases becomes more crucial than ever.Â
Journal Reference Â
Ding, C., Ng Fat, L., Britton, A., Im, P. K., Lin, K., Topiwala, A., … Mehta, G. (2023). Binge-pattern alcohol consumption and genetic risk as determinants of alcohol-related liver disease. Retrieved from https://www.nature.com/articles/s41467-023-43064-xÂ
