A study from Keck Medicine of USC found that heavy drinkers with diabetes, high blood pressure, or a large waistline are up to 2.4 times more likely to develop advanced liver disease. These conditions may amplify alcohol's toxic effects on the liver, leading to severe damage.
Not everyone who drinks the same amount of alcohol faces the same risk of liver disease. A new study published on February 3 in Clinical Gastroenterology and Hepatology by Keck Medicine of USC suggests that three common health conditions — diabetes, high blood pressure, and a high waist circumference — could be key factors. Researchers found that heavy drinkers with any of these conditions are up to 2.4 times more likely to develop advanced liver disease.
"The results identify a very high-risk segment of the population prone to liver disease and suggest that preexisting health issues may have a large impact on how alcohol affects the liver," said Brian P. Lee, MD, MAS, a hepatologist and liver transplant specialist with Keck Medicine and principal investigator of the study.
The Link Between Cardiometabolic Health and the Liver
Diabetes, high blood pressure, and a high waist circumference (defined as over 35 inches for women and 40 inches for men) are part of a group of five cardiometabolic risk factors. These conditions, commonly linked to obesity, also increase the risk of heart attacks and strokes.
Cardiometabolic risk factors have been linked to the buildup of fat in the liver (also known as metabolic dysfunction-associated steatotic liver disease), which can lead to fibrosis, or scarring of the liver. These risk factors affect more than one in three Americans, and cardiometabolic health has been worsening among the population, especially among those under 35, according to Lee.
Rising Alcohol Consumption and Its Consequences
Alcohol also causes fat buildup in the liver, and alcohol consumption has been on the rise since the COVID-19 pandemic, said Lee. Due to the prevalence of both cardiometabolic risk factors and drinking in the United States, Lee and his fellow researchers undertook the study to investigate which cardiometabolic risk factors predisposed the liver to damage from alcohol.
They analyzed data from the National Health and Nutrition Examination Survey, a large national survey of more than 40,000 participants, looking at the intersection of heavy drinking, individual cardiometabolic risk factors and the incidences of significant liver fibrosis. Significant liver fibrosis refers to liver scarring that can lead to liver failure.
For the study, heavy drinking was characterized as 1.5 drinks a day for women (20 grams) and two drinks a day for men (30 grams).
Who Is at the Highest Risk?
Researchers discovered that heavy drinkers with either diabetes or a high waist circumference were 2.4 times more likely to develop advanced liver disease and those with high blood pressure 1.8 times more likely. They found that the other two cardiometabolic risk factors — high triglycerides (elevated levels of a type of fat in the blood) and low HDL (high-density lipoprotein or "good" cholesterol) had less significant correlations to liver disease.
Why Are These Risk Factors So Dangerous?
While the study did not analyze why these three cardiometabolic risk factors are more dangerous for the liver, Lee speculates that these conditions share a common pathway to fat buildup in the liver that when combined with extra fat deposits in the liver from excessive alcohol, can cause significant damage.
Lee emphasizes that the study does not imply it is safe for those without these three cardiometabolic risks to consume large amounts of alcohol. "We know that alcohol is toxic to the liver and all heavy drinkers are at risk for advanced liver disease," he said.
Lee hopes that the study results will encourage people to consider their individual health and risk profile when making decisions about alcohol consumption. He would also like to see practitioners offer more personalized health screenings and interventions for those who drink with cardiometabolic risk factors so that liver damage among this high-risk group can be caught early and treated.
Reference: "Association of Alcohol and Incremental Cardiometabolic Risk Factors with Liver Disease: A National Cross-Sectional Study" by Brian P. Lee, MD, MAS, Justene Molina, MPH, Steve Kim, MPH, Jennifer L. Dodge, MPH and Norah A. Terrault, MD, MPH, 3 February 2025, Clinical Gastroenterology and Hepatology.
DOI: 10.1016/j.cgh.2025.01.003
News
Scientists Discover a New Form of Ice That Shouldn’t Exist
Researchers at the European XFEL and DESY are investigating unusual forms of ice that can exist at room temperature when subjected to extreme pressure. Ice comes in many forms, even when made of nothing but water [...]
Nobel-winning, tiny ‘sponge crystals’ with an astonishing amount of inner space
The 2025 Nobel Prize in chemistry was awarded to Richard Robson, Susumu Kitagawa and Omar Yaghi on Oct. 8, 2025, for the development of metal-organic frameworks, or MOFs, which are tunable crystal structures with extremely [...]
Harnessing Green-Synthesized Nanoparticles for Water Purification
A new review reveals how plant- and microbe-derived nanoparticles can power next-gen water disinfection, delivering cleaner, safer water without the environmental cost of traditional treatments. A recent review published in Nanomaterials highlights the potential of green-synthesized nanomaterials (GSNMs) in [...]
Brainstem damage found to be behind long-lasting effects of severe Covid-19
Damage to the brainstem - the brain's 'control center' - is behind long-lasting physical and psychiatric effects of severe Covid-19 infection, a study suggests. Using ultra-high-resolution scanners that can see the living brain in [...]
CT scan changes over one year predict outcomes in fibrotic lung disease
Researchers at National Jewish Health have shown that subtle increases in lung scarring, detected by an artificial intelligence-based tool on CT scans taken one year apart, are associated with disease progression and survival in [...]
AI Spots Hidden Signs of Disease Before Symptoms Appear
Researchers suggest that examining the inner workings of cells more closely could help physicians detect diseases earlier and more accurately match patients with effective therapies. Researchers at McGill University have created an artificial intelligence tool capable of uncovering [...]
Breakthrough Blood Test Detects Head and Neck Cancer up to 10 Years Before Symptoms
Mass General Brigham’s HPV-DeepSeek test enables much earlier cancer detection through a blood sample, creating a new opportunity for screening HPV-related head and neck cancers. Human papillomavirus (HPV) is responsible for about 70% of [...]
Study of 86 chikungunya outbreaks reveals unpredictability in size and severity
The symptoms come on quickly—acute fever, followed by debilitating joint pain that can last for months. Though rarely fatal, the chikungunya virus, a mosquito-borne illness, can be particularly severe for high-risk individuals, including newborns and older [...]
Tiny Fat Messengers May Link Obesity to Alzheimer’s Plaque Buildup
Summary: A groundbreaking study reveals how obesity may drive Alzheimer’s disease through tiny messengers called extracellular vesicles released from fat tissue. These vesicles carry lipids that alter how quickly amyloid-β plaques form, a hallmark of [...]
Ozone exposure weakens lung function and reshapes the oral microbiome
Scientists reveal that short-term ozone inhalation doesn’t just harm the lungs; it reshapes the microbes in your mouth, with men facing the greatest risks. Ozone is a toxic environmental pollutant with wide-ranging effects on [...]
New study reveals molecular basis of Long COVID brain fog
Even though many years have passed since the start of the COVID-19 pandemic, the effects of infection with SARS-CoV-2 are not completely understood. This is especially true for Long COVID, a chronic condition that [...]
Scientists make huge Parkinson’s breakthrough as they discover ‘protein trigger’
Scientists have, for the first time, directly visualised the protein clusters in the brain believed to trigger Parkinson's disease, bringing them one step closer to potential treatments. Parkinson's is a progressive incurable neurological disorder [...]
Alpha amino acids’ stability may explain their role as early life’s protein building blocks
A new study from the Hebrew University of Jerusalem published in the Proceedings of the National Academy of Sciences sheds light on one of life's greatest mysteries: why biology is based on a very specific set [...]
3D bioprinting advances enable creation of artificial blood vessels with layered structures
To explore possible treatments for various diseases, either animal models or human cell cultures are usually used first; however, animal models do not always mimic human diseases well, and cultures are far removed [...]
Drinking less water daily spikes your stress hormone
Researchers discovered that people who don’t drink enough water react with sharper cortisol spikes during stressful events, explaining why poor hydration is tied to long-term health risks. A recent study in the Journal of Applied [...]
Nanomed Trials Surge Highlighting Need for Standardization
Researchers have identified over 4,000 nanomedical clinical trials in progress now, highlighting rapid growth in the field and the need for a standardized lexicon to support clinical translation and collaboration. Nanotechnology is the science of [...]
