High BMI at reproductive age predisposes women to severe liver disease
Women with a high body mass index (BMI) early in life are at heightened risk of developing severe liver disease later in life, and obesity is associated with the greatest risk, as reported in a recent study.
Researchers examined early pregnancy BMI data from 1,139,458 Swedish women (mean age at the first pregnancy, 28.6 years) in relation to incident severe liver disease (cirrhosis), decompensated liver disease (hepatocellular carcinoma, oesophageal varices, hepatorenal syndrome or hepatic encephalopathy) or liver failure. Liver diseases were ascertained via national registers.
A total of 774 women developed severe liver disease over an average follow-up of 13.8 years. Multivariable Cox regression analysis revealed that compared with women with a low normal BMI (18.5–22.4 kg/m2), those with higher BMI had a significantly elevated risk of developing severe liver disease (22.5–24.9 kg/m2: adjusted hazard ratio [aHR], 1.25; 95 percent CI, 1.04–1.50; 25.0–29.9 kg/m2: aHR, 1.27; 1.05–1.53; ≥30 kg/m2: aHR, 1.77; 1.40–2.24).
In an analysis evaluating BMI as a continuous variable, the risk of incident severe liver disease increased by 4 percent per 1-kg/m2 increase in BMI (aHR, 1.04; 1.02–1.05). Diabetes was also associated with a risk increase independent of baseline BMI.
Additionally, a high BMI was associated with the risk of developing hepatocellular carcinoma, with the risk increase evident in obese (BMI ≥30 kg/m2; aHR, 2.37; 1.06–5.30; p=0.04) but not overweight women. BMI as a continuous parameter was associated with a 5-percent risk increase (aHR, 1.05; 1.00–1.10; p=0.03).
The present data confirm that excess body weight factors in the aetiology of severe liver disease, particularly in the presence of diabetes and in women, researchers said. Overweight/obese women, clinicians and policy‐makers should be aware of this risk and combat the high prevalence of obesity and diabetes to reduce the burden of liver disease on individuals and society.