Liver Disease

Study: Early-Life BMI Predicts Risk of Severe Liver Disease Later in Life

A recent study found that men with a high body mass index (BMI) in late adolescence have an increased risk for severe liver disease and hepatocellular carcinoma later in life. Diagnosis of type 2 diabetes further increased the risk, researchers noted.

For their study, researchers used register data of 1,220,261 Swedish men between 17 and 19 years of age enlisted for conscription between 1969 and 1996. Mean follow-up was 28.5 years. Data on severe liver disease events and the development of type 2 diabetes were obtained through population-based registers. The researchers used 18.5-22.5 kg/m2 BMI as a reference point to estimate hazard ratios (HR) for inpatient care and mortality related to severe liver disease and the risk of hepatocellular carcinoma (HCC) across various BMI categories.
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During follow-up, 5281 cases of severe liver disease were identified, including 251 diagnoses with HCC.

Overall, the researchers found that the risk for severe liver disease was higher in overweight (HR 1.49, 95% CI 1.35 to 1.64) and obese (HR 2.17, 95% CI 1.82 to 2.59) men, compared with normal-weight men.

Likewise, the development of diabetes increased the risk for severe liver disease in all BMI categories. Obese men with diabetes had a higher risk of severe liver disease compared with obese men without diabetes (HR 3.28, 95% CI 2.27 to 4.74 vs HR 1.72, 95% CI 1.72 to 2.54, respectfully).

“This could have implications for public health decision-making, strengthening the need of targeted intervention against overweight and obesity at an early age and specifically highlights the risk of [type 2 diabetes] as a risk factor for liver disease,” the researchers concluded. “Screening of men with [type 2 diabetes] for presence of manifest liver disease using non-invasive, inexpensive scoring systems could be a way forward.” 

—Melissa Weiss

Reference:

Hagström H, Tynelius P, and Rasmussen F. High BMI in late adolescence predicts future severe liver disease and hepatocellular carcinoma: a national, population-based cohort study in 1.2 million men [published online March 20, 2017]. Gut. doi:10.1136/gutjnl-2016-313622.