Liver Adaptation and Injury in Alcoholism

HEPATIC changes are very common in alcoholics, and their development is determined both by the amount and by the duration of ethanol intake.1 The questions most frequently asked are whether these changes are truly caused by alcohol itself or merely by the associated malnutrition, and, if alcohol does have direct effects on the liver, whether they are all injurious, or whether some can be considered adaptive. Regarding the first question, a number of studies conducted over the last 10 years by me and my associates have shown that although nutritional factors are undoubtedly involved, alcohol itself has to be incriminated . . .