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Cited by 630Alcohol Consumption and Health EffectsLiver Disease Diagnosis and TreatmentSubstance Abuse Treatment and Outcomes

Drinking habits as cofactors of risk for alcohol induced liver damage

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Bellentani, S, Saccoccio, G, Costa, G, Tiribelli, C, Manenti, F, Sodde, M, Croce’, L Saveria, Sasso, F +3 more·1997·Gut
DOI 10.1136/gut.41.6.845PMC PMC1891602
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Abstract

Background —The Dionysos Study is a cohort study of the prevalence of chronic liver disease in the general population of two northern Italian communities. It included 6917 subjects, aged 12–65 (69% of the total population). Aims —The aim of this part of the study was to examine the relationship of daily alcohol intake, type of alcoholic beverage consumed, and drinking patterns to the presence of alcohol induced liver damage in an open population. Patients and methods —6534 subjects, free of virus related chronic liver disease and participating in the first cross-sectional part of the study, were fully examined. Each subject underwent: (a) medical history and physical examination, (b) evaluation of alcohol intake using an illustrated dietary questionnaire, and (c) routine blood tests. More invasive diagnostic procedures were performed when indicated. Results —Multivariate analysis showed that the risk threshold for developing either cirrhosis or non-cirrhotic liver damage (NCLD) was ingestion of more than 30 g alcohol per day in both sexes. Using this definition, 1349 individuals (21% of the population studied) were at risk. Of these, only 74 (5.5% of the individuals at risk) showed signs of liver damage. The prevalence of “pure” alcoholic cirrhosis was 0.43% (30 of 6917), representing 2.2% of the individuals at risk, with a ratio of men to women of 9:1, while 44 (3.3% of the individuals at risk) showed persistent signs of NCLD. After 50 years of age, the cumulative risk of developing both NCLD and cirrhosis was significantly higher (p<0.0001) for those individuals who regularly drank alcohol both with and without food than for those who drank only at mealtimes. Conclusions —Our data show that in an open population the risk threshold for developing cirrhosis and NCLD is 30 g ethanol/day, and this risk increases with increasing daily intake. Drinking alcohol outside mealtimes and drinking multiple different alcoholic beverages both increase the risk of developing alcohol induced liver damage.

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  • Spirits consumption and binge drinking outside meals increase the risk of developing liver cirrhosis compared with other alcohol types and drinking patterns.

    “These two behaviors have been shown to increase the risk of developing liver cirrhosis in comparison with other alcohol types and drinking patterns [65–67].”

    From Liver cirrhosis mortality in 187 countries between 1980 and 2010: a systematic analysis (2014) · cites this paper as [65]

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Research works printed but not linked: 4

  1. Cubean J, Pequinot G. La technique du questionnaire alimentaire quantitatif utilise par la section nutrition de l'INSERM. Rev Epidemiol Sante Publique 1980;28:367-72.
  2. Fleiss JL. Statistical methods for rates and proportion. New York: Wiley and Sons, 1981.
  3. Meier P, Beach M. Biostatistics for the clinician. In: Chalmer TC, ed. Data analysis for clinical medicine. Rome: Rome International University Press, 1988:7-29.
  4. Ascione A, Barcellona R, Benini G, Budillon G, Candelaresi MT, Cataldi V, et al. Patologia cronica del fegato in Italia. Inchiesta retrospettiva multicentrica. Rec Prog Med 1977; 63:447-70.

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Authors
Bellentani, S., Saccoccio, G., Costa, G., Tiribelli, C., Manenti, F., Sodde, M., Croce’, L. S., Sasso, F., Pozzato, G., Cristianini, G., & Brandi and the Dionysos Study Group, G.
Affiliations
Fondo per lo Studio delle Malattie del Fegato, Trieste and Modena, Italy
Corresponding author
Bellentani, S
ORCID
Venue
Gut
Publisher
BMJ
Published
1997-12-01
Volume
41
Issue
6
Pages
845-850
ISSN
  • 0017-5749 (ISSN-L)
  • 1468-3288
DOI
10.1136/gut.41.6.845
PMC
PMC1891602
OpenAlex
W2135155547
Cited by
630
References
40
Citations by year
2026: 3 · 2025: 9 · 2024: 13 · 2023: 22 · 2022: 23 · 2021: 26 · 2020: 27 · 2019: 26 · 2018: 39 · 2017: 31 · 2016: 38 · 2015: 44 · 2014: 43 · 2013: 31 · 2012: 30
FWCI
4.38
Type
journal article
Language
en
Open access
Locations
  • Gut (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • ArTS Archivio della ricerca di Trieste (University of Trieste https://www.units.it/) (submittedVersion)
  • HighWire Press Open Archive (submittedVersion)
Topics
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
  • Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Keywords
alcohol-induced liver damage, alcoholic cirrhosis, daily drinking, drinking patterns, risk thresholds, sex differences, age-related risk
MeSH terms
Adolescent, Adult, Age Factors, Aged, Alcohol Drinking, Alcoholic Beverages, Child, Chronic Disease, Female, Humans, Italy, Liver Cirrhosis, Alcoholic, Liver Diseases, Alcoholic, Male, Middle Aged, Risk, Sex Factors, Cohort Studies, Prevalence, Multivariate Analysis

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