Gender Difference in Alcoholic Liver Disease

Alcoholic liver disease occurs after prolonged heavy drinking, particularly among persons who are physically dependent on alcohol. Alcoholic liver disease is pathologically classified into three forms: fatty liver (hepatic steatosis), alcoholic hepatitis, and cirrhosis. There is considerable overlap among these conditions. The incidence of alcoholic liver disease increases in a dose-dependent manner proportionally to the cumulative alcoholic intake. Alcoholism is increasing among females, owing to a decline in the social stigma attached to drinking and to the ready availability of alcohol in supermarkets. In general, however, males have a greater opportunity for drinking. In the United States, the National Comorbidity Survey estimated that, at some time in their lives, 6.4% of females and 12.5% of males will meet the criteria for alcoholic abuse (Kessler et al., 1994). The Italian longitudinal study on aging showed that 42% of elderly females and 12% of elderly males were lifelong abstainers (Buja et al., 2010). In Japan, based on data from the National Nutrition Survey, heavy drinkers with a daily consumption exceeded 40 g of ethanol per day for females and 60 g of ethanol per day for males were more frequently observed in males (Figure 1). Despite the male predominance for alcoholism, chronic alcohol consumption induces more rapid and more severe liver injury in females than males.