Women with Fatty Liver Disease from Alcohol Consumption Face Higher Mortality Risk Than Men, Study Find

A recent study conducted by researchers from the Smidt Heart Institute at Cedars-Sinai and their colleagues has revealed that women diagnosed with fatty liver disease due to alcohol consumption are at nearly double the risk of mortality within a specific timeframe compared to men with the same condition.

The study, published in the esteemed Journal of Hepatology, underscores the imperative for women at risk of liver disease to abstain from excessive alcohol consumption.

Also termed steatotic liver disease, fatty liver disease develops when an excess of fat accumulates in the liver, potentially leading to enduring liver damage. This condition is also associated with an elevated risk of heart disease.

Dr. Susan Cheng, MD, MPH, the director of the Institute for Research on Healthy Aging in the Department of Cardiology at the Smidt Heart Institute and the lead author of the study, emphasized, “Steatotic liver disease is a significant and increasingly prevalent ailment, likely serving as an underlying precursor to numerous conditions, including those affecting the heart. We are increasingly concerned about steatotic liver disease as we observe its close correlation with established cardiovascular risk factors such as hypertension, high cholesterol, and diabetes.”

Recent medical discourse has introduced new terminology to classify distinct types of steatotic liver disease, including metabolic dysfunction-associated steatotic liver disease (MASLD), alcohol-related liver disease (ALD), and metabolic dysfunction-associated and alcohol-related liver disease (MetALD).

The investigators from Cedars-Sinai endeavored to investigate how these variants of steatotic liver disease might manifest differently in men and women.

Data spanning from 1988 to 1994, sourced from the National Health and Nutrition Examination Survey III, were scrutinized by the investigators. The study participants underwent comprehensive medical assessments, including questionnaires, physical examinations, and liver imaging scans, providing insights into alcohol consumption patterns, cardiometabolic risk factors, and liver health.

The analysis encompassed over 10,000 individuals aged 21 and above residing in the United States, with accessible data from liver scans and other medical evaluations. Approximately one-fifth of the cohort, totaling 1,971 individuals, exhibited steatotic liver disease, with MetALD accounting for over 75% of cases. While all forms of steatotic liver disease were approximately twice as prevalent in men compared to women, the data unveiled a significantly elevated risk of mortality among women over a median duration of 26.7 years. For instance, women diagnosed with MetALD faced an 83% higher risk of mortality compared to men without liver disease. Moreover, women afflicted with ALD confronted a mortality risk 160% greater than their male counterparts with ALD.

Dr. Alan Kwan, MD, a research instructor in the Department of Cardiology at Cedars-Sinai and a collaborator on the study, remarked, “These findings are particularly alarming against the backdrop of the COVID-19 pandemic, during which alcohol consumption and associated mortality, particularly among women, have surged.”

Indicators of underlying metabolic liver disease include being overweight or obese, prediabetes or diabetes, high blood pressure, or abnormal blood cholesterol levels. The investigators caution that women exhibiting these risk factors should be particularly vigilant regarding excessive alcohol consumption.

The Centers for Disease Control and Prevention defines moderate alcohol consumption for women as one drink per day or less.

The researchers intend to further explore why alcohol exerts a more pronounced impact on the female liver than the male liver and identify lifestyle modifications, beyond curtailing alcohol intake, that may mitigate a woman’s susceptibility to fatty liver disease.

They underscore that since the study relied on data collected between 1988 and 1994, additional research is imperative to ascertain how the prevalence of liver disease and alcohol consumption patterns may have evolved over time.

Dr. Yee Hui Yeo, MD, and Dr. Hirsh Trivedi, MD, both affiliated with Cedars-Sinai, also contributed to the study.

10 Ways To Reduce Your Risk Of Dementia

Neurologists share tips for maintaining brain health throughout your lifespan

Newswise — Dementia affects millions of Americans — including nearly one in 10 adults over age 65. While the causes of different dementias vary, a 2020 report from a Lancet commission identified several modifiable risk factors that together account for around 40% of dementia worldwide.

This means that many dementia cases might be prevented or delayed by living a healthy lifestyle, said Judith Heidebrink, M.D., a neurologist at University of Michigan Health and co-leader of the Michigan Alzheimer’s Disease Research Center’s Clinical Core.

With the Lancet findings as an anchor, Heidebrink is joined by fellow neurologist and center director Henry Paulson, M.D., to share how you can reduce your risk for dementia and maintain a healthy brain throughout your life.

  1. Keep an eye on your blood pressure

Heidebrink: Aim for a systolic blood pressure of 130 mm Hg or lower in midlife (from around age 40). Research has shown that better control of blood pressure during midlife not only reduces the risk of cognitive impairment and dementia but also of heart attack and stroke.

  1. Protect your hearing

Paulson: Be sure to wear ear protection when you’re around excessive noise exposure to reduce your risk of hearing loss. Also, use hearing aids when needed. A recent study found that older adults who get a hearing aid for newly diagnosed hearing loss have a lower risk of dementia in the following three years.

  1. Support efforts to reduce air pollution

Heidebrink: There is growing evidence linking air pollution, such as the gases and small particles emitted by cars and factories, to cognitive decline and dementia. Encouragingly, sustained improvements in air quality appear to reduce the risk of dementia.

  1. Prevent head injury

Paulson: Physical damage to the brain, including traumatic brain injury, can disrupt normal brain function. Be sure to wear proper protective equipment when playing contact sports or riding a bike, wear a seat belt in cars and see a physician right away if you have concerns about a concussion or TBI.

  1. Limit alcohol use and avoid smoking

Heidebrink: It has long been known that alcohol misuse is associated with damage to the brain and an increased risk of dementia. Limiting alcohol consumption to 1 drink per day appears safest. Smoking tobacco also increases the risk of dementia. Stopping smoking, even later in life, can help reduce the risk.

  1. Stay cognitively engaged

Paulson: People with more years of formal education are at lower risk of dementia than those with fewer years of formal education. This is because keeping your brain cognitively engaged, helps maintain your brain health. Staying cognitively engaged can mean taking a class at a local college or online, or challenging your mind with puzzles, games or a new hobby. Socializing with others also engages your brain, so keeping up with friends and family is helpful.

  1. Follow a heart healthy diet and maintain regular exercise throughout life

Paulson: A good rule of thumb is, “If it’s good for your heart, it’s also good for your brain.” Eating a well-rounded diet full of fruits, vegetables, and healthy fats (such as the Mediterranean diet) can help maintain a healthy weight and mitigate the risk of obesity, high blood pressure, high cholesterol and diabetes, which are known to contribute to dementia in later life.

SEE ALSO: What’s The Difference Between Dementia & Alzheimer’s Disease (uofmhealth.org)

Maintaining a regular exercise routine — 150 minutes of moderate to intense physical activity throughout your week — helps to maintain good cardiovascular health to ward off dementia.

People often forget how important simple aerobic exercise is for the brain. A brisk walk, or a stint on a stationary bike, three times a week helps your brain work better. And it’s good for your body, too.

  1. Maintain healthy sleep patterns

Heidebrink: Sleep benefits the mind in many ways. It gives the brain a chance to lock in memories and enhances the ability to learn new skills. Current research suggests that sleep disturbances like sleep apnea may be linked to a greater risk of developing dementia. Getting enough quality sleep could help reduce your risk.

  1. Stay socially engaged

Paulson: Studies suggest that remaining socially active throughout life may support brain health and possibly reduce the risk of dementia. Schedule regular social outings to stay socially connected with friends and family, or choose a social activity that is meaningful to you, such as volunteering or participating in community groups.

  1. Take care of your mental health

Heidebrink: Some studies have linked a history of depression to dementia in later life. Maintaining social activities and hobbies can help ward off depression, and physical activity can help reduce stress. If you experience signs of depression, anxiety, or another mental health concern, be sure to discuss these with your health care provider.

It’s important to note that many dementia risk factors disproportionately affect minority ethnic groups.

“In addition to taking steps as individuals to decrease our own dementia risk, we should take steps as a society to ensure that everyone has equitable access to an environment and resources that promote brain health,” Heidebrink said.

For more information about dementia, including Alzheimer’s disease, Lewy body dementia, vascular dementia, frontotemporal dementia and more, visit the Michigan Alzheimer’s Disease Center website.

Many research studies are also available to contribute to our understanding of dementia, including studies that further investigate dementia in at-risk populations. If you are interested in joining a research study, please contact the Michigan Alzheimer’s Disease Center at 734-936-8332 for a full list of recruiting studies.

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