Rates of liver disease and obesity are increasing in the UK. While alcohol is a major cause of liver cirrhosis, recent evidence suggests that excess body weight may also play a role.
The first study, conducted by University of Oxford researchers, saw examination of the link between body mass index (BMI)* and liver cirrhosis in 1.2 million middle-aged UK women as part of the Million Women Study.
Each participant was followed for an average of 6.2 years, and risks were adjusted for factors such as age, alcohol consumption, smoking, socioeconomic status and physical activity.
Compared to women of a healthy weight, women who were overweight or obese had an increased relative risk of liver cirrhosis. Although this relative risk did not differ significantly by alcohol consumption, the absolute risk did.
In the second study, researchers from the Universities of Glasgow and Bristol investigated the joint effects of BMI and alcohol consumption on liver disease in more than 9,000 men in Scotland. Participants were tracked for an average of 29 years.
Both factors were related to liver disease and, more importantly, the combination of high BMI and alcohol consumption was greater than the additive effect of the two separate factors.
The two studies conclude that, from a public health perspective, strategies to jointly reduce both excessive alcohol consumption and excessive body weight should lead to a reduction in the incidence of liver disease.
Future research must focus on better diagnosis and treatment of non-alcoholic fatty liver disease (a build-up of fat in the liver caused by obesity, high alcohol intake and diabetes, which can lead to cirrhosis).
In the meantime, the old adage of "prevention is better than cure" remains pertinent. Reducing alcohol consumption and obesity are, at present, our only weapons against non-viral liver disease. The progression of non-alcoholic fatty liver disease to end stage liver disease can now be added to the list of the undesirable consequences of modern lifestyles.
*Body mass index (BMI) is a measure of body fat based on height and weight that applies to both adult men and women. CLICK HERE for a quick calculation of your BMI
Bette Liu, Angela Balkwill, Gillian Reeves, Valerie Beral, on behalf of the Million Women Study Collaborators. Body mass index and risk of liver cirrhosis in middle aged women in UK: prospective study. BMJ. 2010 Mar 11;340:c912.
Carole L Hart, David S Morrison, G David Batty, Richard J Mitchell, George Davey Smith. Effect of body mass index and alcohol consumption on liver disease: analysis of data from two prospective cohort studies. BMJ. 2010 Mar 11;340:c1240.Picture: http://www.argutusmed.com