Binge Drinking and the Risk of Liver Events

Binge drinking or heavy episodic drinking is increasingly prevalent, but the health effects are incompletely understood. We investigated whether binge drinking increases the risk for liver disease above and beyond the risk due to average alcohol consumption.
6366 subjects without baseline liver disease who participated in the Finnish population-based Health 2000 Study (2000-2001), a nationally representative cohort. Follow-up data from national registers until 2013 were analysed for liver-related admissions, mortality and liver cancer. Binge drinking (≥5 drinks per occasion, standard drink 12 g ethanol) was categorised as weekly, monthly, or as less often or none. Multiple confounders were considered.
Eighty-four subjects developed decompensated liver disease. Binge drinking frequency showed a direct association with liver-disease risk after adjustment for average daily alcohol intake and age. After adjustment, the hazard ratios for weekly and monthly binge drinking were 3.45 (P=.001) and 2.26 (P=.007) and were higher after excluding regular heavy drinkers. The hazard ratios for weekly binging was 6.82 (P=.02) in women; 2.34 (P=.03) in men; and 4.29 (P=.001) in subjects with the metabolic syndrome. Weekly binge drinking and the metabolic syndrome produced supra-additive increases in the risk of decompensated liver disease. Weekly, and to a lesser extent monthly, binging retained significance in sequential multivariate models that additionally adjusted for beverage preference and lifestyle, metabolic, and socioeconomic factors.
Binge drinking is associated with an increased risk for liver disease independently of average alcohol intake and confounders. The rising prevalence of binge drinking and the metabolic syndrome is particularly concerning.
* This Finnish cohort study followed more than 6000 adult patients over a mean period of 11 years. Binge drinking was defined as ≥5 drinks containing 12 g of ethanol per occasion, and had a marked association with decompensated liver disease (hospitalization due to liver disease, liver-related death, or diagnosis of primary liver cancer) after adjustment for age and average daily alcohol use. The hazard ratios for weekly binging and monthly binging were 3.45 and 2.26, respectively. In patients with metabolic syndrome, weekly binging had a synergistic effect (hazard ratios rising to 4.29) for development of decompensated liver disease.
* This study highlights the dose-related risks of binge drinking in the development of liver disease, especially when combined with metabolic syndrome.
– Zurabi Lominadze, MD
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Liver International: Official Journal of the International Association for the Study of the Liver