Liver Damage Surges Among Heavy Drinkers

New Study Reveals Alarming Rise in Advanced Fibrosis

Advanced liver scarring linked to heavy alcohol consumption has more than doubled in the U.S. over the past two decades, a troubling trend emerging despite stable overall drinking rates.

Risk Factors Magnify Danger

Researchers have identified several demographic groups at higher risk for severe alcohol-related liver injury. These include women, individuals aged 45 and older, those facing poverty, and people with metabolic syndrome.

“Alcohol-related liver disease is the main cause of liver-related death, and these results are a major wake-up call to the dangers of drinking.”

—Brian Lee, MD, MAS, Hepatologist and Liver Transplant Specialist

The findings, published in Clinical Gastroenterology and Hepatology, analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2020.

Sharp Increase in Scarring

The study tracked a significant metric for advanced liver scarring, the Fibrosis-4 (FIB-4) score, among heavy drinkers, defined as consuming at least 20 grams of alcohol daily for women and 30 grams for men. Among this group, the prevalence of high FIB-4 scores more than doubled from 1.8% in 1999-2004 to 4.3% in 2013-2020.

Conversely, the increase among non-heavy drinkers was much smaller, rising from 0.8% to 1.4% over the same period. Crucially, average alcohol consumption per person remained unchanged during the study years.

Metabolic Syndrome and Aging Compounds Risk

During the study period, metabolic syndrome prevalence climbed from 26.4% to 37.6% among heavy drinkers. The average age of heavy drinkers also increased, alongside a greater proportion of women and individuals living in poverty, factors known to exacerbate alcohol’s impact on the liver.

Even when restricting the analysis to adults aged 35-65 or to pre-pandemic years (1999-2018), similar upward trends were confirmed, with significant liver scarring tripling over two decades.

This rise in liver damage aligns with broader public health concerns. For instance, the Centers for Disease Control and Prevention (CDC) reported a 40% increase in alcohol-related deaths between 2019 and 2020 alone (CDC, 2021).

Urgent Call for Intervention

The researchers noted limitations, including the reliance on self-reported alcohol intake and the use of FIB-4 as a surrogate marker. However, they concluded that the findings highlight a population becoming more vulnerable to alcohol’s liver effects due to escalating underlying risk factors.

The study underscores the urgent need to raise awareness about the escalating risks of alcohol-related liver disease and to implement targeted interventions for screening and treating contributing risk factors.