Alcohol drinking pattern and risk of alcoholic liver cirrhosis: A prospective cohort study
Abstract
Background & aims Alcohol is the main contributing factor of alcoholic cirrhosis, but less is known about the significance of drinking pattern.Methods We investigated the risk of alcoholic cirrhosis among 55,917 participants (aged 50-64 years) in the Danish Cancer, Diet, and Health study (1993-2011). Baseline information on alcohol intake, drinking pattern, and confounders was obtained from a questionnaire. Follow-up information came from national registers. We calculated hazard ratios (HRs) for alcoholic cirrhosis in relation to drinking frequency, lifetime alcohol amount, and beverage type.Results We observed 257 and 85 incident cases of alcoholic cirrhosis among men and women, respectively, none among lifetime abstainers. In men, HR for alcoholic cirrhosis among daily drinkers was 3.65 (95% CI: 2.39; 5.55) compared to drinking 2-4 days/week. Alcohol amount in recent age periods (40-49 and 50-59 years) was associated with an increased risk, whereas the amount in 20-29 and 30-39 years was not. In men drinking 14-28 drinks/week, HR was 7.47 (95% CI: 1.68; 33.12), 3.12 (95% CI: 1.53; 6.39), and 1.69 (95% CI: 0.79; 3.65) in drinkers of little (<1% of weekly amount), some (1-15%), and mostly wine (50-100%), compared to drinking <14 drinks/week. In general, results were similar for women.Conclusions In men, daily drinking was associated with an increased risk of alcoholic cirrhosis. Recent alcohol consumption rather than earlier in life was associated with risk of alcoholic cirrhosis. Compared to beer and liquor, wine might be associated with a lower risk of alcoholic cirrhosis.
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Heavy long-term alcohol consumption accelerates the transition of alcoholic fatty liver into alcoholic hepatitis.
“Heavy long-term alcohol consumption accelerates the transition of alcoholic fatty liver into alcoholic hepatitis, which is characterized by steatosis, ballooning hepatocytes, and infiltration of neutrophils with or without fibrosis [11,12,13,14,15,16].”
From Pathophysiological Aspects of Alcohol Metabolism in the Liver (2021) · cites this paper as [16]
In women, cirrhosis risk increases with moderate alcohol consumption (starting at one to two drinks per day) and is higher when alcohol is consumed daily and outside meals.
“In women, cirrhosis risk increases with moderate alcohol consumption (starting at one to two drinks per day) and is higher when alcohol is consumed daily 94 and outside meals.”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [94]
Given the same amount of overall alcohol exposure, days without any alcohol consumption ('liver holidays') have been shown to be associated with a lower risk than daily drinking.
“More specifically, given the same amount of overall alcohol exposure, days without any alcohol consumption (‘liver holidays’) have been shown to be associated with a lower risk than daily drinking 284, 285.”
From The relationship between different dimensions of alcohol use and the burden of disease—an update (2017) · cites this paper as [285]
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- Authors
- Askgaard, G., Grønbæk, M., Kjær, M. S., Tjønneland, A., & Tolstrup, J. S.
- Affiliations
- University of Southern Denmark (DK)
- Copenhagen University Hospital (DK)
- Danish Cancer Society (DK)
- Corresponding author
- Askgaard, Gro
- Venue
- Journal of Hepatology
- Publisher
- Elsevier BV
- Published
- 2015-05
- Volume
- 62
- Issue
- 5
- Pages
- 1061-1067
- ISSN
- 0168-8278 (ISSN-L)
- OpenAlex
- W2037276679
- Cited by
- 256
- References
- 5
- Citations by year
- 2026: 10 · 2025: 16 · 2024: 22 · 2023: 24 · 2022: 37 · 2021: 27 · 2020: 25 · 2019: 26 · 2018: 29 · 2017: 15 · 2016: 18 · 2015: 7
- FWCI
- 18.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Pharmacology › Coffee research and impacts
- Keywords
- alcoholic cirrhosis, alcohol drinking patterns, drinking frequency, daily drinking, beverage type, wine, beer, alcoholic beverages, sex differences, middle-aged adults
- MeSH terms
- Alcohol Drinking, Alcoholic Beverages, Denmark, Female, Humans, Liver Cirrhosis, Alcoholic, Male, Middle Aged, Prospective Studies, Surveys and Questionnaires, Risk Factors, Time Factors, Cohort Studies, Incidence
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