The combined effect of alcohol and body mass index on risk of chronic liver disease: A systematic review and meta-analysis of cohort studies
The combined effect of alcohol and body mass index on risk of chronic liver disease: A systematic review and meta-analysis of cohort studies
Background & Aims: Increasingly populations are both overweight/obese and consume alcohol. The risk of liver disease from the combination of these factors is unclear. We performed a systematic review and meta-analysis to address this important gap in evidence. Protocol registered with PROSPERO(CRD42016046508). Methods: We performed electronic searches of Ovid Medline, Embase Classic + Embase, until 17th June 2020 for cohort studies of adults without pre-existing liver disease. Primary outcome was morbidity/mortality from chronic liver disease. Exposures were alcohol consumption categorised as within or above UK recommended limits (14 units/112 g per week) and BMI categorised as normal, overweight or obese. Non-drinkers were excluded. A Poisson regression log-linear model was used to test for statistical interaction between alcohol and BMI and to conduct a one-stage meta-analysis. Results: Searches identified 3129 studies—16 were eligible. Of these, nine cohorts (1,121,514 participants) had data available and were included in the analysis. The Poisson model showed no significant statistical interaction between alcohol consumption and BMI on the risk of chronic liver disease. Compared to normal weight participants drinking alcohol within UK recommended limits, relative risk of chronic liver disease in overweight participants drinking above limits was 3.32 (95% CI 2.88 to 3.83) and relative risk in obese participants drinking above limits was 5.39 (95% CI 4.62 to 6.29). Conclusions: This meta-analysis demonstrated a significantly increased risk of chronic liver disease in participants who were both overweight/obese and consumed alcohol above UK recommended limits. This evidence should inform advice given to patients and risk stratification by healthcare professionals.
alcohol, chronic liver disease, cirrhosis, meta-analysis, obesity
Bohning, Dankmar
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Parkes, Julie
59dc6de3-4018-415e-bb99-13552f97e984
Roderick, Paul
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Buchanan, Ryan
9499f713-f684-4046-be29-83cd9d6f834d
Bohning, Dankmar
1df635d4-e3dc-44d0-b61d-5fd11f6434e1
Parkes, Julie
59dc6de3-4018-415e-bb99-13552f97e984
Roderick, Paul
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Buchanan, Ryan
9499f713-f684-4046-be29-83cd9d6f834d
Glyn-Owen, Kate, Bohning, Dankmar, Parkes, Julie, Roderick, Paul and Buchanan, Ryan
(2020)
The combined effect of alcohol and body mass index on risk of chronic liver disease: A systematic review and meta-analysis of cohort studies.
Liver International.
(doi:10.1111/liv.14754).
Abstract
Background & Aims: Increasingly populations are both overweight/obese and consume alcohol. The risk of liver disease from the combination of these factors is unclear. We performed a systematic review and meta-analysis to address this important gap in evidence. Protocol registered with PROSPERO(CRD42016046508). Methods: We performed electronic searches of Ovid Medline, Embase Classic + Embase, until 17th June 2020 for cohort studies of adults without pre-existing liver disease. Primary outcome was morbidity/mortality from chronic liver disease. Exposures were alcohol consumption categorised as within or above UK recommended limits (14 units/112 g per week) and BMI categorised as normal, overweight or obese. Non-drinkers were excluded. A Poisson regression log-linear model was used to test for statistical interaction between alcohol and BMI and to conduct a one-stage meta-analysis. Results: Searches identified 3129 studies—16 were eligible. Of these, nine cohorts (1,121,514 participants) had data available and were included in the analysis. The Poisson model showed no significant statistical interaction between alcohol consumption and BMI on the risk of chronic liver disease. Compared to normal weight participants drinking alcohol within UK recommended limits, relative risk of chronic liver disease in overweight participants drinking above limits was 3.32 (95% CI 2.88 to 3.83) and relative risk in obese participants drinking above limits was 5.39 (95% CI 4.62 to 6.29). Conclusions: This meta-analysis demonstrated a significantly increased risk of chronic liver disease in participants who were both overweight/obese and consumed alcohol above UK recommended limits. This evidence should inform advice given to patients and risk stratification by healthcare professionals.
Text
Glyn-Owen_final_liver_int
- Accepted Manuscript
More information
Accepted/In Press date: 1 December 2020
e-pub ahead of print date: 7 December 2020
Additional Information:
Funding Information:
KGO and RB were funded by fellowships from the National Institute for Health Research (NIHR) Applied Research Collaboration for Wessex (ARC). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.
Publisher Copyright:
© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Keywords:
alcohol, chronic liver disease, cirrhosis, meta-analysis, obesity
Identifiers
Local EPrints ID: 445565
URI: http://eprints.soton.ac.uk/id/eprint/445565
ISSN: 1478-3223
PURE UUID: 0603ff5c-55e1-4be8-85d1-a31d6c9f41d3
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Date deposited: 16 Dec 2020 17:31
Last modified: 10 Apr 2024 04:05
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Author:
Kate Glyn-Owen
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