Timing matters: circadian rhythm disruption in alcohol-associated peripheral organ pathophysiology

Circadian rhythms influence the pathophysiological effects of alcohol. This review examines how alcohol disrupts circadian regulation in peripheral organs, particularly the liver, intestine, cardiovascular system, and skeletal muscle, and how circadian disruption exacerbates metabolic dysfunction and organ injury. Evidence from preclinical and human studies indicates that both genetic and environmental circadian disruption increases alcohol-induced gut permeability, systemic inflammation, and liver disease. This review also presents how other lifestyle and environmental factors such as diet, smoking, and shift work worsen circadian disruption and alcohol-related toxicity. Emerging circadian-based therapeutic strategies and key research priorities are discussed. Advancing understanding of alcohol-circadian interactions is essential for developing more effective, personalized treatments for alcohol-associated diseases.