"Increased Alcohol-Related Mortality Even with Elevated Liver Enzymes Without Underlying Diseases"

People with high liver enzyme levels have a 31% higher mortality rate even at 'normal drinking amounts'
Professor Kwak Geum-yeon: "If ALT is high, even 1-2 shots of soju should be avoided"

[Asia Economy Reporter Lee Gwan-joo] A study has found that even mild alcohol consumption increases the risk of death in people with elevated liver enzyme levels (ALT) without underlying diseases.

According to Samsung Seoul Hospital on the 17th, a research team led by Professors Kwak Geum-yeon and Shin Dong-hyun from the Department of Gastroenterology, and Professors Jo Joo-hee and Kang Dan-bi from the Clinical Epidemiology Research Center recently published results comparing the risk of death according to alcohol consumption between people with normal and elevated blood ALT levels.

The research team evaluated the impact of alcohol consumption on mortality in 367,612 individuals without any underlying liver disease who had undergone at least one health checkup between 2009 and 2015 in the National Health Insurance Service national cohort. They assessed the effect based on elevated ALT levels (≥34 U/L for men, ≥25 U/L for women). Alcohol consumption was classified according to the American Association for the Study of Liver Diseases guidelines into non-drinkers, light drinkers (less than 10g for women, less than 20g for men), moderate drinkers (10-40g for women, 20-60g for men), and problematic drinkers (40g or more for women, 60g or more for men).

In the group with normal ALT levels, light or moderate drinking did not significantly affect the risk of death from liver disease. However, in the group with elevated ALT levels, light and moderate drinkers had 1.57 times and 2.09 times higher risk of death from liver disease, respectively, compared to non-drinkers. Considering various factors beyond liver disease causes, the overall mortality rate in the elevated ALT group was about 31% higher for moderate drinkers compared to non-drinkers.

Liver disease often goes unnoticed in its early stages due to lack of symptoms, leading many to continue drinking without realizing liver damage. One well-known test to detect early liver damage is measuring blood ALT levels. ALT is an enzyme present in liver cells, and when the liver is damaged, ALT is released from the damaged liver cells into the bloodstream, causing elevated blood levels. The increase in ALT due to liver damage occurs before clear symptoms such as jaundice appear, making it an inexpensive and easy method to detect early liver damage.

Professor Kwak Geum-yeon explained, “Even if there is no underlying liver disease, people with elevated ALT levels should refrain from even small amounts of alcohol consumption, which means less than one glass of soju per day for women and less than two glasses of soju per day for men.”

Meanwhile, this study was recently published in the international academic journal 'BMC MEDICINE'.

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