Amsterdam, The Netherlands, Thursday 25 April 2013: Research announced today at the International Liver CongressTM 2013 has revealed the deadly impact that alcohol and body weight have on liver disease.

Women should forgo the wine and doughnuts after a new study found the harmful combination of high alcohol intake and high body mass index (BMI) causes an increased risk of chronic liver disease. The study analysed a cohort of over 107,000 women to investigate how a female's weight and alcohol consumption affected their chances of suffering and dying from chronic liver disease.

EASL's Scientific Committee Member Dr. Daniele Prati said this research involved a large study to investigate the combined influence of a person's alcoholic intake and BMI on the liver.

Dr. Prati said: "It's well known that alcohol and a person's weight are major causes of chronic liver disease however there has been a need for a large population study to compare these factors' influences on each other. Interestingly, the research found the combination of a woman's drinking habits and weight has an important effect on liver health and life expectancy."

More than 107,000 women across the United Kingdom who took part in the study were classed with a low or high BMI (<25 or ≥ 25) and a low or high alcohol intake (between 0-15 or over 15 units per week). BMI is a measure for human body shape based on an individual's weight and height, with people scoring ≥ 25 classified as overweight. The study found risk was significantly increased in the group of women with a high BMI and high alcohol intake, with these participants more likely to suffer from chronic liver disease.

Dr. Prati explained: "These findings will have a significant impact on how we can help millions of people across the world at risk of developing liver disease. Women are at particular risk as they are twice as sensitive as men to alcohol related liver damage and developing a more severe form of the disease at lower doses with shorter durations of alcohol consumption. Based on this research we know that a person with low BMI and high alcoholic intake have a greater risk of developing chronic liver disease compared to a woman with a high BMI who doesn't drink very much. More research is required to determine the exact thresholds for each risk factor that independently and in combination increase the risk of chronic liver disease but this is an important first step in the right direction."

Other new research released at the congress showcased a strong link between the development of hepatocellular carcinoma (HCC) in alcoholic cirrhosis patients and metabolic fatty liver disease. The study found that patients with alcoholic cirrhosis who also have fatty liver disease and are overweight, obese or type 2 diabetic are more likely to develop HCC.

The research examined 100 patients who received transplants for alcoholic end stage liver disease to analyse the impact of both fatty liver and metabolic risk factors such as obesity and type 2 diabetes on the development of HCC in patients.

The results showed more patients with HCC had been frequently overweight (54% compared to 14% of non-HCC patients) or diabetic (43% compared to 22% of non-HCC patients). Half (50%) of patients who had fatty liver disease and were overweight, obese or had type 2 diabetes were found to have HCC compared to just 6% of patients with HCC without these other conditions.

Dr. Prati commented: "Fatty liver and alcohol have long been known as risk factors for HCC but this study tested their combined effect in patients with alcoholic cirrhosis. These findings show patients suffering from alcoholic cirrhosis who also have a history of fatty liver disease, obesity or type 2 diabetes have a higher risk of developing liver cancer. The results will be useful to improve the management of patients with cirrhosis, and to identify cancer at early stages."

Worldwide, HCC accounts for approximately 5.4% of all cancers and causes 695,000 deaths per year, including 47,000 deaths in Europe per annum.

Europe has the highest rate of alcohol consumption in the world with one in seven adults consuming more than the recommended average daily amount.

Disclaimer: the data referenced in this release is based on the submitted abstract. More recent data may be presented at the International Liver Congress™ 2013.

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Notes to Editors

About EASL

EASL is the leading European scientific society involved in promoting research and education in hepatology. EASL attracts the foremost hepatology experts and has an impressive track record in promoting research in liver disease, supporting wider education and promoting changes in European liver policy.

EASL's main focus on education and research is delivered through numerous events and initiatives, including:

The International Liver CongressTM which is the main scientific and professional event in hepatology worldwide



Meetings including Monothematic and Special conferences, Post Graduate courses and other endorsed meetings that take place throughout the year



Clinical and Basic Schools of Hepatology, a series of events covering different aspects in the field of hepatology



Journal of Hepatology published monthly



published monthly Participation in a number of policy initiatives at European level

About The International Liver CongressTM 2013

The International Liver Congress™ 2013, the 48th annual meeting of the European Association for the study of the Liver, is being held at the RAI Convention Centre in Amsterdam from April 24 - 28, 2013.

The congress annually attracts in excess of 9000 clinicians and scientists from around the world and provides an opportunity to hear the latest research, perspectives and treatments of liver disease from principal experts in the field.

References:

1 Trembling PM, INFLUENCE OF BMI AND ALCOHOL ON LIVER-RELATED MORBIDITY AND MORTALITY IN A COHORT OF 108,000 WOMEN FROM THE GENERAL POPULATION FROM UKCTOCS. Presented at the International Liver CongressTM 2013

2 Sato N, Lindros KO, Baraona E, Ikejima K, Mezey E, Jarvelainen HA, et al. Sex difference in alcohol-related organ injury. Alcohol Clin Exp Res. 2001;25:40S- 45S.

3 Pais, R. METABOLIC FATTY-LIVER DISEASE INCREASES THE RISK OF HEPATOCELLULAR CARCINOMA IN PATIENTS WITH ALCOHOLIC CIRRHOSIS LISTED FOR LIVER TRANSPLANTATION. Presented at the International Liver CongressTM 2013

4 Kumar Vinay, Nelso Fausto and Abul Abbas. Robbins & Cotran Pathologic Basis of Disease, 7th ed. Saunders; 2004.

5 Cancer fact sheet. World Health Organisation. February 2006. http://www. who. int/ mediacentre/ factsheets/ fs297/ en/ Accessed 04.04.12

6 EU Burden of Liver Disease: A review of available epidemiological data. European Association for the Study of the Liver Disease. 2013.