Health UK (Commonwealth Union) – New research from the University College London (UCL), the Royal Free Hospital, the University of Oxford, and the University of Cambridge reveals that individuals with a particular genetic makeup who engage in binge drinking are six times more likely to develop alcohol-related cirrhosis (ARC). Published in Nature Communications, this groundbreaking study is the first to examine how an individual’s drinking pattern, genetic profile (measured by a polygenic risk score), and the presence of type-2 diabetes collectively influence the risk of developing ARC.
The study emphasizes that the pattern of drinking holds more significance than the volume consumed. The risk of developing ARC was three times higher for those engaged in heavy binge drinking, defined as consuming 12 units in a day at some point during a week. Additionally, individuals with a high genetic predisposition faced a fourfold increase in risk, while those with type-2 diabetes had a twofold increase.
Liver disease stands as a major global cause of premature death, affecting 2-3% of the world’s population with cirrhosis or liver disease. Notably, alcohol-related deaths have surged by 20% since the onset of the COVID-19 pandemic as indicated by researchers of the study.
Examining data from 312,599 actively drinking adults in the UK Biobank cohort, the researchers assessed the impact of drinking patterns, genetic predisposition, and type-2 diabetes on ARC likelihood. A baseline hazard ratio (HR) of one was established using data from participants who adhered to daily drinking limits, had a low genetic predisposition to ARC, and were free of diabetes.
The study underscores that when heavy binge drinking and a high genetic predisposition coincide, the risk of developing ARC escalates to six times the baseline risk. The inclusion of type-2 diabetes further amplifies this risk, revealing the intricate interplay of these factors in liver disease vulnerability. Dr. Linda Ng Fat, a lead author of the study from UCL Epidemiology & Public Health, noted that the research’s unique focus on drinking patterns provided a more accurate indicator of liver disease risk compared to volume alone. Additionally, the study highlights the cumulative impact of multiple risk factors on the heightened risk of developing ARC.
Dr Gautam Mehta, a senior author of the study from UCL Division of Medicine as well as the Royal Free Hospital, says “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.”
While polygenic risk scores are currently not widely employed in clinical settings, they are anticipated to gain increased prominence as a means of determining personalized disease risk.
Dr. Steven Bell, a senior author of the research conducted at the University of Cambridge, emphasized the importance of adopting innovative strategies to tackle the rising crisis of liver disease, particularly alcohol-related fatalities, which have surged significantly since the onset of the COVID-19 pandemic. He highlighted that the study provides novel tools crucial for identifying individuals at the highest risk, allowing interventions to be directed more effectively towards those who would benefit the most.
Pamela Healy, Chief Executive of the British Liver Trust added “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.”
