Alcoholic liver disease: Natural history

A lcohol consumption was identified as a risk factor for liver disease centuries ago when Laennec documented a high prevalence of cirrhosis among heavy drinkers. 1Modern epidemiological data from many societies confirm a strong correlation between death attributable to cirrhosis and per capita consumption of alcohol. 2 No particular quantity of alcohol consumption predictably results in alcoholic liver disease (ALD).Although evidence suggests that risk increases with habitual alcohol intake of 80 g/d in men and 20 g/d in women, a minority of individuals drinking two to three times these amounts develop significant liver disease.Indeed, only 20% of men drinking the equivalent of two six-packs of beer daily for 10 years become cirrhotic. [3][4]4][5] Hence, most people who drink alcohol do not become cirrhotic, but some people who drink only modestly may develop this lesion.