Alcohol and the Liver- the deal
· 10 to 20 % of population in the western world expected to abuse alcohol
· Oldest known medicine/ chemical to man
· Brain likes it and Liver helps the brain receive it after receiving from Gut
Risk factors of developing alcoholic liver disease depends on various risk factors
(a) Qunatity:
Alcohol content is estimated to be the beverage volume (in mL) multiplied by its percentage of alcohol.
For example, the alcohol content of 40 mL of an 80-proof (40% alcohol) beverage is 16 mL by volume.
Each mL contains about 0.79 g of alcohol.
Although values can vary, the percentage of alcohol averages 2 to 7% for most beers and 10 to 15% for most wines.
Thus, a 12-oz glass of beer contains about 3 to 10 g of alcohol, and an 8-oz glass of wine contains about 10 to 15 g.
Duration of consumption is very imp too
(b)Sex; Women are 2 times as prone to alcoholic liver disease as men
©Type: it is generally accepted that beer and spirit consumption , increases the risk more than others
(d)coexistent morbidity of liver including all varieties of hepatitis
(e)Malnutrition; particularly low proteins and vitamins like A& E
(f) Genetic factors : Some individuals are more susceptible than others –possibly depends on enzymatic presence and family history of fatmetabolism disorders, hypertension, diabetes etc
(g) Iron overload- serum iron increase increases the risk
Mechanism of damage:
Alcohol------by action of ADH(alcohol dehydrogenase)---acetaldehyde--------by action of ALDH(acetaldehyde dehydrogenase)-----acetic acid----by oxidation---------Co2and water
These oxidative reactions generate hydrogen, which converts nicotinamide-adenine dinucleotide (NAD) to its reduced form (NADH), increasing the redox potential (NADH/NAD) in the liver.
fatty acid accumulation----liver cells –coupled with glycerol---Triglycerides–
----heaptocytes macrovesicular fat globules accumulation
Ultrasonography is usually adequate for demonstration of fatty liver changes
Liver functions remain normal until atleast 75% of the liver is damaged
• Manifests as
• Fatty liver (in > 90%)-----reversible
• Alcoholic hepatitis (in 10 to 35%)—reversible
• Cirrhosis (in 10 to 20%)-usually irreversible
Fatty liver(steatosis ) has other common causes like obesity, diabetes and inherent fat metabolism errors, drugs, infections, idiopathic
