Friday, 27 May 2016

Pass the liver salts

Just off to the pub for a pint

Whilst a student, many years ago, I remember my Microbiology Professor distinctly lecturing us students about the dangers of alcohol. Students, as I'm sure you know, have a reputation for enjoying the hedonist lifestyle and therefore his entreaties fell on deaf ears and young livers. What this had to do with microbes I can't recall, but Teachers from time immemorial have never been able to resist foisting 'wisdom' on their impressionable students which they feel is lacking in young minds and hearts. One particular Prof comment has stayed with me: "Men with hairy chests are less likely to contract cirrhosis of the liver than their brethren scant of chest hair". The class dutifully laughed and some quickly checked their attributes. At the time I didn't take the comment seriously and as the Prof offered no references to support his pronouncement I was inclined to treat it with mild jocular disdain. Now all this would be just a footnote in my timeline if it wasn't for something which occurred last week while trawling through the net.

Due to my training and natural inclination I am not someone who usually takes information, especially if obtained from the net, as dripping in verity. Tis always best to go back to the original study or hopefully studies which provide data and support for the assertion. The site I was browsing is not particularly renowned for imparting unimpeachable knowledge so I rarely take its contents too seriously. I usually go there for casual amusement and to find ideas for my writing. Anyway, what piqued my interest was the following unsupported comment: Men with hair on their chests are less likely to get cirrhosis of the liver than bare-chested men are. Perhaps my old teetotal Prof was on to something or could it be no more than a medical urban legend? As typical for this site no references were given. This would require a bit of digging.

It didn't take long to come up with a primary source. During the 1950s and 60s an American liver specialist, Dr Mitchell Spellberg, conducted research into the connection between hirsutism and liver disease. In May 1961 the good doctor attended the 62nd annual meeting of the American Gastroenterological association in Chicago. During the meeting he held a press conference to alert the public to the association between lack of a hairy chest and liver disease and to warn men less endowed to limit their alcohol consumption. To quote the good doctor: "The bushy chested individual is probably endowed with more protection against alcohol than his bare chested brother." I Couldn't help think that there was a good dollop of old fashioned morality preaching going on here- that doesn't mean the doc was wrong in his assertion though. 

Certainly by the 1960s there was 'evidence' for a link between liver disease and a lack of a hairy chest. But as all good scientists should know, correlation is not necessarily causation. Correlation is a very pesky fellow and should be treated with circumspection. For instance, could it be that liver disease results in hair loss? Mayhap the data is flawed in some way; was the study a good one adhering to sound scientific principles; was there any conscious or unconscious bias involved. The opposite is also true: If you treat everything with total scepticism, you learn nothing but how to sneer. Good science is, and should always be, bloody hard work.  

There have been studies conducted subsequent to Dr Spellberg's initial work of varying quality (see below). My tentative interpretation is that there might be something going on but I suspend final judgement pending new studies; not exactly clear cut but thought provoking nonetheless. If we are looking at a real phenomenon how could it be mediated? One possible suspect is the male hormone testosterone. Hormones can play an important role in disease, especially cancer. Testosterone levels have been shown to influence chest hair growth and alcohol processing in the liver. It has been suggested that men with less testosterone degrade alcohol less efficiently than men with higher testosterone levels. I must emphasise that there is no hard evidence for this and the idea, for now, remains a hypothesis. 

It will come as no surprise that I enjoy the odd tipple. Also I have very little chest hair, just a few wispy strands which I comb over to hide my unsightly third nipple. Am I therefore at significant risk of developing cirrhosis? I don't think so- my drinking is not that profound and any increase in risk is likely to be low. Cirrhosis is not a particularly common disease despite what your doctor might say. I'm much more likely to succumb to cancer or maybe heart disease as I have raised cholesterol. I'll be buggered if I'll change my lifestyle. I enjoy life and all the good things therein. I don't believe in an afterlife and intend to continue to live my life as if tomorrow will be my last sunrise. 

But don't take my word for it. Check out the primary sources yourself if you have the time or inclination. This list is not exhaustive and only contains the papers which I could be bothered to read. 

1. Gibbons, R (May 27, 1961). "Bare-Chested Males Advised: Don't Drink." Chicago Daily Tribune: 8.
2. Grace, WJ, et al. (1962). Chest Hair and Cirrhosis of the Liver. American Journal of Digestive Diseases, 7(10): 913-914.
3. Kumar, N & Anand, BS (May 1998). Premorbid Hair Growth over the Trunk and Severity of Alcohol-Related Liver Disease. Digestive Diseases and Sciences, 43(5): 1111-1115.
4. Selzer, R (1976). Mortal Lessons: Notes on the Art of Surgery. Harcourt.
5. Saxon, F & Mugumbo, I (June 2016). Alcohol consumption and the link with talking complete bollocks. Tipton Journal of Difficult Shit and Stuff, 23 (8): 126-129.



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