UB Study Shows How and When You Drink, Not Only How Much, Is Important to Liver Health, Especially in Women

BUFFALO, N.Y. -- In the first study of drinking patterns and their relationship to potential liver damage, University at Buffalo epidemiologists have found that how and when drinkers consume alcohol may be as important to a healthy liver as the amount consumed.

Moreover, their findings revealed gender differences in the effect of drinking on the liver. In men, the amount and frequency of drinking were more important than pattern, while in women, pattern appeared to be more important than the amount consumed.

Results of the study will be presented on June 13 by lead author Saverio Stranges, M.D., research instructor in the UB Department of Social and Preventive Medicine in the School of Public Health and Health Professions, at the Society for Epidemiologic Research meeting in Atlanta.

Stranges and colleagues assessed levels of liver enzymes as biomarkers of liver damage in 2,943 white men and women between the ages of 35 and 80. In addition to providing fasting blood samples, participants answered detailed questions about their health and their alcohol intake. Levels of liver enzymes, primarily of GGT, the most sensitive of three liver enzymes that become elevated in response to alcohol consumption, then were analyzed in relation to a variety of drinking patterns and levels of consumption reported by participants.

Stranges found that the men who drank daily had the highest levels of GGT, while in women, GGT levels were highest in those who drank only on weekends.

A gender difference related to drinking pattern also persisted when researchers compared results for those who reported drinking primarily with or without food. Women who didn't eat or snack when they drank had higher levels of GGT than women who drank primarily with a meal, even though the amount of alcohol was the same. In men, there was no significant difference in GGT levels between those who drank with food and those who didn't.

Not surprisingly, the amount of alcohol men and women could consume without causing potential liver damage, based on GGT levels, also differed. Results showed that the safe range for men was 14-27 drinks-per-week, or no more than three a day; for women, the safe range was 7-14 drinks-per-week, or no more than two a day.

There is no clear answer at this time as to why drinking patterns have a greater impact on women than men, Stranges said. "This greater susceptibility to hepatic damage in women may be the result of differences in how the sexes metabolize alcohol. There may also be other risk factors associated with specific drinking patterns, contributing to the differences. These are questions that we need to address with further studies.

"The suggestion is, if you drink, drink in moderation and in a healthy way, with food, and spread the consumption over a longer period of time, rather than in a short period, such as a weekend," Stranges said.

Also contributing to the study were Jo L. Freudenheim, Ph.D., professor, and Paola Muti, M.D., associate professor, both of the UB Department of Social and Preventive Medicine; Eduardo Farinaro, M.D., of the University of Naples Medical School; Marcia Russell, Ph.D., of the Prevention Research Center in Berkeley, Calif.; Thomas H. Nochajski, Ph.D., associate professor in the UB School of Social Work, and Maurizio Trevisan, M.D., professor and interim dean of the UB School of Public Health and Health Professions.

The study was funded in part by a grant from the National Institute on Alcohol Abuse and Alcoholism.