Effects of Heavy Drinking Episodes and Volume of Drinking on Liver Enzymes

This study aimed to assess whether patterns of alcohol consumption are associated with liver enzyme changes. Researchers studied the effects of heavy episodic drinking (defined as >60g of alcohol on one occasion for men, >40g for women) and levels of average daily alcohol consumption* on markers of hepatotoxicity (ALT, GGT, CRP**) in a large Finnish population survey.

• Among the 8597 men, 91% reported “low-risk” alcohol consumption, 6% “medium-risk,” and 3% “high-risk.”
• Among the 9733 women, 94% reported “low-risk” consumption, 5% “medium-risk,” and 1% “high-risk.”
• Compared with people who had no heavy episodic drinking, there was a significant increase in GGT among both men and women with any heavy drinking episodes; an increase in ALT was observed in men but not in women.
• In analyses taking into account both the total volume of alcohol consumed and the frequency of heavy drinking episodes, there was a linear increase in liver enzymes as a function of the total alcohol volume.
• Among participants reporting “low-risk” drinking, significant increases in GGT and ALT were observed in participants with more than one heavy drinking episode in a month. The same was observed for CRP among men but not women.

* Average daily alcohol consumption was classified as “low-risk” (1–40g for men, 1–20g for women), “medium-risk” (41–60g for men, 21–40g for women), and “high-risk” (61–100g for men, 41–60g for women).

** Alanine aminotransferase (ALT), Gamma-glutamyl transferase (GGT), and C-reactive protein (CRP).

Comments: In addition to the negative impact of the total volume of alcohol consumed, this study suggests that there are negative effects of heavy drinking episodes even among those whose total volume of alcohol was categorized as “low-risk” drinking. Taking drinking patterns into account is therefore important when providing patients with information on unhealthy alcohol use.

Nicolas Bertholet, MD, MSc

Reference: Nivukoski U, Bloigu A, Bloigu R, et al. Liver enzymes in alcohol consumers with or without binge drinking. Alcohol. 2019;78:13–19.