The combined effect of alcohol and obesity on risk of liver disease: a systematic review and meta-analysis
Year: 2019
Type: conference-paper
Study designs: Systematic Review, Meta-Analysis
Abstract: Liver disease caused by alcohol and obesity is preventable by risk factor modification. Evidence from individual studies on risk in patients with both risk factors is inconsistent. We performed a systematic review and meta-analysis to quantify the risk of liver disease associated with combinations of BMI and alcohol consumption. Study protocol is registered with PROSPERO (CRD42016046508). Inclusion criteria: English language publications; adults from general population cohorts without pre-existing liver disease; BMI and alcohol quantifiably measured. Outcomes: incident morbidity/mortality from cirrhosis and/or hepatocellular carcinoma. A one-stage meta-analysis was performed on original count data, using a Poisson regression log-linear model. 2589 studies were identified. 50 underwent full text review. Eight cohorts (Two from the USA, six from Europe) were included in the meta-analysis, totalling 1,029,962 participants. There was no interaction between alcohol and obesity in the model. Risks of liver disease in those with both increased BMI and alcohol consumption were significantly increased and were multiplicative, as per the properties of the log-linear model (figure 1). Compared to normal weight participants drinking <14 units/wk, the relative risk of liver disease in those who were overweight and drinking above limits was 3.60 (95%CI 3.22-4.02) and the relative risk in those who were obese and drinking above limits was 5.84 (95%CI 5.09–6.70).Overweight and obese patients drinking >14 units/wk are at significantly increased risk of liver disease. This risk should inform lifestyle advice given to patients and risk stratification. The current UK guidelines for alcohol consumption may not be appropriate for obese patients.
Authors: Glyn-Owen, Kate Anne, Parkes, Julie, Bohning, Dankmar, Roderick, Paul, Buchanan, Ryan
Institution: University of Southampton
Language: English
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7074672846