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The combined effect of alcohol and obesity on risk of liver disease: a systematic review and meta-analysis

The combined effect of alcohol and obesity on risk of liver disease: a systematic review and meta-analysis
The combined effect of alcohol and obesity on risk of liver disease: a systematic review and meta-analysis
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.
chronic liver disease, body mass index (bmi), alcohol consumption, relative risk, meta-analysis, cohort studies
Glyn-Owen, Kate Anne
5973f869-c528-4c3e-96fa-f17636e17022
Parkes, Julie
59dc6de3-4018-415e-bb99-13552f97e984
Bohning, Dankmar
1df635d4-e3dc-44d0-b61d-5fd11f6434e1
Roderick, Paul
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Buchanan, Ryan
9499f713-f684-4046-be29-83cd9d6f834d
Glyn-Owen, Kate Anne
5973f869-c528-4c3e-96fa-f17636e17022
Parkes, Julie
59dc6de3-4018-415e-bb99-13552f97e984
Bohning, Dankmar
1df635d4-e3dc-44d0-b61d-5fd11f6434e1
Roderick, Paul
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Buchanan, Ryan
9499f713-f684-4046-be29-83cd9d6f834d

Glyn-Owen, Kate Anne, Parkes, Julie, Bohning, Dankmar, Roderick, Paul and Buchanan, Ryan (2019) The combined effect of alcohol and obesity on risk of liver disease: a systematic review and meta-analysis. British Association for the Study of the Liver (BASL) Annual Meeting 2019, , Glasgow, United Kingdom. 17 - 20 Sep 2019.

Record type: Conference or Workshop Item (Poster)

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.

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More information

Published date: September 2019
Venue - Dates: British Association for the Study of the Liver (BASL) Annual Meeting 2019, , Glasgow, United Kingdom, 2019-09-17 - 2019-09-20
Keywords: chronic liver disease, body mass index (bmi), alcohol consumption, relative risk, meta-analysis, cohort studies

Identifiers

Local EPrints ID: 445420
URI: http://eprints.soton.ac.uk/id/eprint/445420
PURE UUID: 4605710d-b1ad-4b50-a3ee-db3a340ebf75
ORCID for Kate Anne Glyn-Owen: ORCID iD orcid.org/0000-0001-7934-2684
ORCID for Julie Parkes: ORCID iD orcid.org/0000-0002-6490-395X
ORCID for Dankmar Bohning: ORCID iD orcid.org/0000-0003-0638-7106
ORCID for Paul Roderick: ORCID iD orcid.org/0000-0001-9475-6850

Catalogue record

Date deposited: 08 Dec 2020 17:31
Last modified: 18 Feb 2021 17:29

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Contributors

Author: Kate Anne Glyn-Owen ORCID iD
Author: Julie Parkes ORCID iD
Author: Dankmar Bohning ORCID iD
Author: Paul Roderick ORCID iD
Author: Ryan Buchanan

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