Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Women and alcoholic liver disease — warning of a silent danger

Alcohol use and 'social' drinking are increasing among the young and particularly in women. However, gender equity does not extend to the risk of alcohol-associated liver disease and alcoholic hepatitis, which are increased and often caused by as little as half as much cumulative alcohol consumption in women compared with men.

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.

Figure 1: Factors contributing to increased risk of alcohol-associated liver disease in women.


  1. 1

    Louvet, A. & Mathurin, P. Alcoholic liver disease: mechanisms of injury and targeted treatment. Nat. Rev. Gastroenterol. Hepatol. 12, 231–242 (2015).

    Article  PubMed  Google Scholar 

  2. 2

    Wilkinson, P., Kornaczewski, A., Rankin, J. G. & Santamaria, J. N. Physical disease in alcoholism. Initial survey of 1,000 patients. Med. J. Aust. 1, 1217–1223 (1971).

    CAS  Article  PubMed  Google Scholar 

  3. 3

    Saunders, J. B., Davis, M. & Williams, R. Do women develop alcoholic liver disease more readily than men? Br. Med. J. 282, 1140–1143 (1981).

    CAS  Article  Google Scholar 

  4. 4

    Yamauchi, M. Alcoholic liver disease in women. Japan Med. Associ. J. 45, 111–117 (2002).

    Google Scholar 

  5. 5

    Shimizu, I., Kamochi, M., Yoshikawa, H. & Nakayama, N. in Trends in Alcoholic Liver Disease Research — Clinical and Scientific Aspects (ed. Shimizu, I.) Ch. 2 (InTech, 2012).

    Book  Google Scholar 

  6. 6

    Spain, D. M. Portal cirrhosis of the liver. A review of two hundred fifty necropsies with references to sex differences. Am. J. Clin. Pathol. 15, 215–218 (1945).

    Article  Google Scholar 

  7. 7

    Szabo, G. & Petrasek, J. Gut-liver axis and sterile signals in the development of alcoholic liver disease. Alcohol Alcohol. 52, 414–424 (2017).

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  8. 8

    Bala, S., Marcos, M., Gattu, A., Catalano, D. & Szabo, G. Acute binge drinking increases serum endotoxin and bacterial DNA levels in healthy individuals. PLoS ONE 9, e96864 (2014).

    Article  PubMed  PubMed Central  Google Scholar 

  9. 9

    Ikejima, K. et al. Estrogen increases sensitivity of hepatic Kupffer cells to endotoxin. Am. J. Physiol. 274, G669–676 (1998).

    CAS  PubMed  Google Scholar 

  10. 10

    Colantoni, A., Emanuele, M. A., Kovacs, E. J., Villa, E. & Van Thiel, D. H. Hepatic estrogen receptors and alcohol intake. Mol. Cell Endocrinol. 193, 101–104 (2002).

    CAS  Article  PubMed  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to Gyongyi Szabo.

Ethics declarations

Competing interests

The author declares no competing financial interests.

PowerPoint slides

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Szabo, G. Women and alcoholic liver disease — warning of a silent danger. Nat Rev Gastroenterol Hepatol 15, 253–254 (2018).

Download citation


Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing