Obesity and overweight in relation to liver disease mortality in men: 38 Year follow-up of the original Whitehall study (original) (raw)
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Assessment of risk factors and complications of liver diseases in a tertiary care hospital
Aim: To assess the risk factors and complications of liver disease in a tertiary care hospital with the main objectives of identifying the relation between liver disease and its risk factors, smoking, alcohol consumption and obesity. Methods: A prospective observational study was conducted in a tertiary care hospital from August 2018 to February 2019. The data was collected with the consent of the patient from the case sheets and also by personally questioning the patient regarding the social habits, previous medical and medication history. The results of the data were obtained by performing statistical analysis of the study using Chi-square test. Results: From the study it is observed that the prevalence of liver disease was more in males (89%) than in females (11%). The study also suggests that the risk of developing the cirrhosis of liver is more in smokers (52%) than in nonsmokers (31%). The study clearly depicts that obese and overweight individuals are at an increased risk of developing the liver disease compared to the normal individuals.
Obesity-Associated Liver Disease
The Journal of Clinical Endocrinology & Metabolism, 2008
In the last few years, several data have accumulated suggesting that obesity may be associated with liver disease and disease progression. Accordingly, the worldwide epidemic of obesity is likely to become a relevant source of morbidity and mortality in the general population. Evidence Acquisition: We reviewed the literature on two main issues: 1) the evidence that obesity carries out an increased risk of liver disease, both in the general population and in selected cohorts; and 2) the evidence that obesity is a risk factor for nonalcoholic fatty liver disease and its progression in a series observed in liver units. Evidence Synthesis: The presence of obesity increases the risk of elevated liver enzymes by a factor of two to three, whereas the risk of steatosis at ultrasonography is increased by a factor of 3 in the presence of overweight and peaks at a factor of approximately 15 in the presence of obesity. Both cirrhosis (cryptogenic cirrhosis) and hepatocellular carcinoma are also associated with obesity in the general population. In patients with nonalcoholic fatty liver disease observed in liver units, obesity and weight gain are systematically associated with advanced fibrosis and fibrosis progression. Conclusion: Liver disease of metabolic origin, associated with obesity, is now recognized as the most prevalent liver disease in Western countries. Strategies are needed to approach obesityassociated liver disease by behavior programs, motivating people to adopt a healthier lifestyle. Such programs should be coupled with public policies at a societal level to obtain the maximum effects in lifestyle changes.
Annals of Hepatology, 2020
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New metrics for the Lancet Standing Commission on Liver Disease in the UK
Lancet (London, England), 2016
Panel 1: The 8 Recommendations R1: Improving expertise & facilities in primary care to strengthen detection of early disease and its treatment, & screening of high-risk patients in the community. R2: Establishment of acute liver services in district general hospitals linked with 30 regional specialist centres for complex investigations & treatment, & increased provision of medical & nursing training in hepatology R3: A national review of liver transplantation to ensure better access for patients to increase capacity R4: Specialist paediatric services & continuity of care in transition arrangements for children with liver disease reaching adult life. R5: Measures to reduce overall alcohol consumption in the country R6: Promotion of healthy lifestyles to reduce obesity & the burden of NAFLD R7: Eradication of chronic HCV infection from the country by 2030 & a major reduction in the burden of disease for hepatitis B. R8: Increasing awareness of liver disease in the general population & within the NHS; work of liver patient support groups.
Gastroenterology, 2003
Background & Aims: Our aim was to determine whether increased body mass index (BMI) in the general population is associated with cirrhosis-related death or hospitalization. Methods: Participants included 11,465 persons aged 25-74 years without evidence of cirrhosis at entry into the study, or during the first 5 years of followup, who subsequently were followed-up for a mean of 12.9 years. The BMI was used to categorize participants into normal-weight (BMI < 25 kg/m 2 , N ؍ 5752), overweight (BMI 25 to < 30 kg/m 2 , N ؍ 3774), and obese categories (BMI > 30 kg/m 2 , N ؍ 1939). Results: Cirrhosis resulted in death or hospitalization of 89 participants during 150,233 person-years of follow-up (0.59/1000 person-years). Cirrhosis-related deaths or hospitalizations were more common in obese persons (0.81/1000 person-years, adjusted hazard ratio 1.69, 95% confidence interval [CI] 1.0-3.0) and in overweight persons (0.71/1000 person-years, adjusted hazard ratio 1.16, 95% CI 0.7-1.9) compared with normal-weight persons (0.45/1000 person-years). Among persons who did not consume alcohol, there was a strong association between obesity (adjusted hazard ratio 4.1, 95% CI 1.4-11.4) or being overweight (adjusted hazard ratio 1.93, 95% CI 0.7-5.3) and cirrhosis-related death or hospitalization. In contrast, this association was weaker among persons who consumed up to 0.3 alcoholic drinks/day (adjusted hazard ratio 2.48, 95% CI 0.7-8.4 for obesity; adjusted hazard ratio 1.31, 95% CI 0.4-4.2 for overweight) and no association was identified among those who consumed more than 0.3 alcoholic drinks/ day. Conclusions: Obesity appears to be a risk factor for cirrhosis-related death or hospitalization among persons who consume little or no alcohol.
Fatty liver index and mortality: The cremona study in the 15th year of follow-up
Hepatology, 2011
A fatty liver, which is a common feature in insulin-resistant states, can lead to chronic liver disease. It has been hypothesized that a fatty liver can also increase the rates of non-hepaticrelated morbidity and mortality. Therefore, we wanted to determine whether the fatty liver index (FLI), a surrogate marker and a validated algorithm derived from the serum triglyceride level, body mass index, waist circumference, and c-glutamyltransferase level, was associated with the prognosis in a population study. The 15-year all-cause, hepatic-related, cardiovascular disease (CVD), and cancer mortality rates were obtained through the Regional Health Registry in 2011 for 2074 Caucasian middle-aged individuals in the Cremona study, a population study examining the prevalence of diabetes mellitus in Italy. During the 15-year observation period, 495 deaths were registered: 34 were hepatic-related, 221 were CVD-related, 180 were cancer-related, and 60 were attributed to other causes. FLI was independently associated with the hepatic-related deaths (hazard ratio 5 1.04, 95% confidence interval 5 1.02-1.05, P < 0.0001). Age, sex, FLI, cigarette smoking, and diabetes were independently associated with all-cause mortality. Age, sex, FLI, systolic blood pressure, and fibrinogen were independently associated with CVD mortality; meanwhile, age, sex, FLI, and smoking were independently associated with cancer mortality. FLI correlated with the homeostasis model assessment of insulin resistance (HOMA-IR), a surrogate marker of insulin resistance (Spearman's q 5 0.57, P < 0.0001), and when HOMA-IR was included in the multivariate analyses, FLI retained its association with hepatic-related mortality but not with all-cause, CVD, and cancer-related mortality. Conclusion: FLI is independently associated with hepatic-related mortality. It is also associated with all-cause, CVD, and cancer mortality rates, but these associations appear to be tightly interconnected with the risk conferred by the correlated insulin-resistant state. (HEPATOLOGY 2011;54:145-152) See Editorial on Page 6 N onalcoholic fatty liver disease (NAFLD) is common in insulin-resistant subjects 1 and affects 20% to 30% of the adult population and more than 50% of overweight and obese individuals. 2
Hepatology, 2019
BaCKgRoUND aND aIMS: Nonalcoholic fatty liver disease (NAFLD) encompasses a range of conditions, from simple steatosis to nonalcoholic steatohepatitis. Studies in the United States have reported an increased mortality risk among individuals with NAFLD; therefore, the population attributable fractions (PAFs) for mortality were examined. appRoaCH aND ReSUltS: A total of 12,253 adult individuals with ultrasound assessment of NAFLD from the Third National Health and Nutrition Examination Survey and mortality follow-up through 2015 were included in the analysis. Cox proportional hazard regression was used to estimate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for NAFLD in association with all-cause and cause-specific mortality. Overall, sex-and race/ethnicity-specific PAFs and 95% CIs were estimated. In the current study, presence of NAFLD was associated with a 20% increased risk of all-cause mortality (HR, 1.20; 95% CI, 1.08, 1.34). The overall PAF for all-cause mortality associated with NAFLD was 7.5% (95% CI, 3.0, 12.0). The PAF for diabetes-specific mortality was 38.0% (95% CI, 13.1, 63.0) overall, 40.8% (95% CI, 2.1, 79.6) in men, and 36.8% (95% CI, 6.6, 67.0) in women. The PAF for liver disease (LD)-specific mortality was notably higher in men (68.3%; 95% CI, 36.3, 100.0) than women (3.5%; 95% CI, −39.7, 46.8). In the race-specific analysis, the PAFs of NAFLD for all-cause mortality (9.3%; 95% CI, 4.0, 14.6) and diabetes-specific mortality (44.4%; 95% CI, 10.8, 78.0) were significantly greater than zero only for whites. CoNClUSIoNS: In the United States, approximately 8% of all-cause mortality and more than one-third of LD-and diabetesspecific deaths are associated with NAFLD. With these high percentages, efforts are needed to reduce the burden of NAFLD in the United States. (Hepatology 2020;72:430-440). N onalcoholic fatty liver disease (NAFLD) encompasses a range of histopathological conditions, from mild steatosis to severe nonalcoholic steatohepatitis (NASH). (1) NAFLD has become the most common cause of chronic liver disease (CLD) worldwide and can lead to serious
Overweight, obesity and risk of liver cancer: a meta-analysis of cohort studies
British journal of cancer, 2007
Cohort studies of excess body weight and risk of liver cancer were identified for a meta-analysis by searching MEDLINE and EMBASE databases from 1966 to June 2007 and the reference lists of retrieved articles. Results from individual studies were combined using a random-effects model. We identified 11 cohort studies, of which seven on overweight (with a total of 5037 cases) and 10 on obesity (with 6042 cases) were suitable for meta-analysis. Compared with persons of normal weight, the summary relative risks of liver cancer were 1.17 (95% confidence interval (CI): 1.02-1.34) for those who were overweight and 1.89 (95% CI: 1.51-2.36) for those who were obese. This meta-analysis finds that excess body weight is associated with an increased risk of liver cancer.