People who binge drink and have a certain genetic makeup are six times more likely to develop alcohol-related cirrhosis, according to new research from the Royal Free Hospital, University College London (UCL), the University of Oxford and the University of Cambridge.

The study, published in Nature Communications, is the first to assess how an individual’s pattern of drinking, their genetic profile and whether or not they have type-2 diabetes affects their risk of developing alcohol-related cirrhosis (ARC). 

Around 2-3% of the world’s population suffer from cirrhosis (scarring of the liver) or liver disease. Globally, it is one of the major causes of premature death and since the COVID-19 pandemic began, alcohol-related fatalities have risen by 20%.

In this study, researchers analysed data from 312,599 actively drinking adults in the UK Biobank cohort, to assess the impact of pattern of drinking, genetic predisposition and type-2 diabetes on the likelihood of developing ARC.

Those who engaged in heavy binge drinking, which is categorised as having 12 units in a day at some point during a week, were three times as likely to develop ARC. The risk for those with a high genetic predisposition was four times higher and the risk for type-2 diabetics was two times higher.

When heavy binge drinking and high genetic predisposition were at play, the risk of developing ARC was six times higher than the baseline risk which used data from participants who reported drinking within daily limits, had low genetic disposition to ARC and were free of diabetes. The addition of type-2 diabetes as well resulted in an even greater risk.

Dr Gautam Mehta, (pictured below), a senior author of the study from the Royal Free Hospital and UCL division of medicine, said: "Only one in three people who drink at high levels go on to develop serious liver disease.

"While genetics plays a part, this research highlights that pattern of drinking is also a key factor. Our results suggest, for example, that it would be more damaging to drink 21 units over a couple of sessions rather than spread evenly over a week.

"Adding genetic information, which may be widely used in healthcare over the coming years, allows an even more accurate prediction of risk."


He added: "Although we suspected it was the case I think it still surprised all of us who took part in the research how the interaction within the body between the risk factors thrust people into such an extremely high risk category.

"On a practical level what this means is if we know someone is a binge drinker and has diabetes we could potentially also look to offer genetic testing to identify those most at risk and look at delivering targeted early lifestyle intervention to attempt to reduce that risk. This research could help policy makers in the not too distant future.”

Pamela Healy, chief executive of the British Liver Trust, said: "This research is important because it reveals that it’s not just how much you drink overall but the way that you drink matters. Drinking a lot, quickly, or drinking to get drunk can have serious consequences for your liver health.

"Over the last 20 years, as alcohol has become more accessible and affordable, there has been a disconcerting shift in the UK's drinking culture.

"The UK needs to tackle increased alcohol consumption through a joined up ‘alcohol strategy’ that includes taxation, stronger controls on alcohol advertising and marketing and improved awareness of the dangers of binge drinking."