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The question of why some people who drink excessive amounts of alcohol develop cirrhosis of the liver and others who drink equally excessive amounts do not incur such damage has yet to be answered. It is clear from the results of certain studies, however, that more factors are involved in alcohol-related liver damage than simply the degree to which a person abuses alcohol.
For example, Lelbach (1976) analyzed a series of 23 studies involving 5,448 alcohol-abusing(1) patients with known or suspected alcohol-induced liver disease. A sample of liver tissue was obtained from each patient and examined under the microscope so that the actual degree of alcohol damage to the liver was established in all patients. It generally is accepted that the course of alcohol-induced liver damage starts with fatty liver, often progresses through alcoholic hepatitis, and finally results in cirrhosis. The Lelbach evaluation showed that approximately 25 percent of the alcohol-abusing subjects had a normal liver, 33 percent had fatty liver, 20 percent had alcoholic hepatitis, and 25 percent had progressed to cirrhosis.
The wide range of alcohol-induced liver damage found in this study shows that alcohol abuse alone does not determine a person's susceptibility to liver disease.(2) Other factors also are involved, some of which may be related to gender. It may be that women are more prone than men to develop alcohol-induced cirrhosis. Indeed, a good amount of evidence points to women's greater susceptibility, but analysis thus far has not been sufficient to rid this hypothesis of controversy.
The purpose of this article is to review the information available and present a case supporting gender as a factor influencing susceptibility to alcohol-related liver damage. We begin by briefly examining the actual physiological differences between the way women's and men's bodies respond to alcohol. Next, we review the data, posing two questions. First, among patients of both genders with alcoholic cirrhosis, have the women consumed less and/or consumed it for a shorter period of time than the men? Second, among patients of both genders with liver damage who stop drinking, are the women more likely to develop cirrhosis than the men?
Gender-Related Differences in Developing Cirrhosis
Women Are Different. Gender-related differences in susceptibility to alcoholic liver disease may be related to differences in the...