Teen drinkers could face liver damage over next four decades

Teens who start drinking early could be setting themselves up for liver damage over the next four decades, a study warned.

Their drinking can predict the risk of developing liver disease later in life and the findings suggested safe drinking limits needed to be lowered.

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In the UK men and women are advised not to drink more than 14 units a week on a regular basis with one unit equal to 10ml or 8g of pure alcohol.

Lead investigator Dr Hannes Hagström at Karolinska University Hospital, Stockholm, said: "Our study showed that how much you drink in your late teens can predict the risk of developing cirrhosis later in life.

"However, what can be considered a safe cut-off in men is less clear."

The retrospective study assessed the association between alcohol consumed early in life with later development of severe liver disease.

It used data from 49,000 Swedish conscripts aged 18 to 20 during 1969 to 1970 and national medical and death records to establish whether any had developed severe liver disease up to the end of 2009.

The findings indicated alcohol consumption early in life was associated with an increased risk of developing severe liver disease.

After 39 years of follow-up, 383 men had developed severe liver disease, which was defined as a diagnosis of liver cirrhosis, decompensated liver disease (hepatocellular carcinoma, ascites, esophageal varices, hepatorenal syndrome, or hepatic encephalopathy), liver failure, or death from liver disease.

The risk was dose-dependent, with no sign of a threshold effect and was more pronounced in men consuming two drinks per day, about 20 grams, or more.

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Before adjustment for body mass index, tobacco consumption, the use of narcotics, cardiovascular fitness, and cognitive ability, the risk was significant for daily alcohol consumption as low as six grams per day.

Dr Hagström added: "If these results lead to lowering the cut-off levels for a 'safe' consumption of alcohol in men, and if men adhere to recommendations, we may see a reduced incidence of alcoholic liver disease in the future."

Dr Alexandre Louvet at the Hôpital Huriez in Lille, France in an editorial noted despite the huge disease burden, there are no approved treatments for alcoholic liver disease.

He said: "The present study adds to our knowledge about the risks of chronic alcohol consumption at a younger age.

Safety first

"Safe levels of alcohol consumption must be revised for the general population and public health policies must be adapted accordingly.

"General recommendations by physicians must be accompanied by alcohol-control policies, especially access to alcohol, prices, and advertising.

" Education and information are not sufficient on their own to reduce alcohol consumption in the general population.

"On the other hand, targeted interventions aimed at identifying and advising excessive drinkers are useful on an individual level."

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Alcohol-related liver disease (ARLD) is the liver damage caused by excess alcohol drinking and does not usually cause any symptoms until the liver has been severely damaged.

Currently there are no specific medical treatment for ARLD with the main treatment is to stop drinking, preferably for the rest of the patient's life to reduce the risk of further liver damage and to give it the best chance of recovering.

The study was published in the the Journal of Hepatology.