Arria A M, Tarter R E, Van Thiel D H
Department of Psychiatry, University of Pittsburgh School of Medicine, Pennsylvania 15213.
Recent Dev Alcohol. 1991;9:185-204.
Epidemiological evidence suggests a direct relationship between alcohol consumption and the prevalence of cirrhosis. However, the observation that only 8-30% of alcoholics develop cirrhosis illustrates that individual susceptibility mediates the relationship between alcohol consumption and cirrhosis. This chapter examines the factors that may influence individual risk for alcoholic liver disease. These factors include individual differences in alcohol metabolism and consumption patterns, gender, HLA antigens, family alcoholism history, and immune responsiveness. Important methodological issues in each of these areas are addressed also. From the available evidence, the hypothesis is advanced that there is an underlying vulnerability to liver disease in some individuals, and that alcohol use, although a necessary condition, is not sufficient to trigger disease in all individuals.
流行病学证据表明饮酒与肝硬化患病率之间存在直接关系。然而，仅有8% - 30%的酗酒者会发展为肝硬化这一观察结果表明，个体易感性在饮酒与肝硬化的关系中起中介作用。本章探讨了可能影响个体患酒精性肝病风险的因素。这些因素包括酒精代谢和饮酒模式的个体差异、性别、人类白细胞抗原（HLA）、家族酗酒史以及免疫反应性。还讨论了这些领域中每个领域的重要方法学问题。根据现有证据，提出了一个假说，即某些个体存在潜在的肝脏疾病易感性，饮酒虽然是必要条件，但不足以在所有个体中引发疾病。
