In order to assist in the discovery of mechanisms and prediction of risk, apart from lifetime alcohol exposure to produce alcohol-related cirrhosis, patients were evaluated, noting that sustained alcoholic intake is necessary, but not sufficient to produce alcohol related cirrhosis
A multi-center, case-controlled study (GenomALC) comparing 1293 cases (with alcoholrelated cirrhosis, 75.6% male), and 754 controls (with equivalent alcohol exposure, but no evidence of liver disease, 73.6% male) was carried out. Information confirming or excluding cirrhosis and on alcoholic intake and other potential risk factors was obtained from clinical recurs and by interview. Case-control differences and risk factors discovered in the GenomALC participants was validated using similar data from 407 cases and 6573 controls from UK Biobank.
The GenomALC case and control groups reported similar lifetime alcoholic intake (1374 vs 1412 kg). Cases had a higher prevalence of diabetes (20.5% vs 6.5%), and higher pre-morbid body mass index (26.37), than controls (24.4). Controls are significantly more likely to have been wine drinkers, coffee drinkers, smokers, and cannabis users than cases. Cases reported a higher proportion of parents who died of liver disease than controls (OR 2.25). Data from UK Biobank confirmed these findings with diabetes, BMI, proportion of alcohol as wine, and coffee consumption.
If these relationships can be identified as causal, measures such as weight loss, intensive treatment of diabetes or prediabetic states, and coffee consumption should reduce the risk of alcohol-related cirrhosis.
Whitfield, J., Masson, S., Liangpunsakul, S., et al. for the GenomALC Consortium. “Obesity, Diabetes, Coffee, Tea, and Cannabis Use Alter Risk for Alcohol-Related Cirrhosis in Two Large Cohorts of High-Risk Drinkers.” American Journal of Gastroenterology; January 2021, Vol. 16, pp. 106-115.