Overweight and at risk

On the association between BMI and liver disease

March 21, 2017 12:15 am | Updated 12:25 am IST

03dmc obesity

03dmc obesity

Men who become overweight and obese from an early age are at a higher risk of developing severe liver disease and even liver cancer, according to a new study. The risk is increased when they develop diabetes.

The study, “High BMI in late adolescence predicts future severe liver disease and hepatocellular carcinoma: a national, population-based cohort study in 1.2 million men”, published in the journal Gut , is based on the data of more than 1.2 million Swedish men enlisted for military conscription between 1969 and 1996. Compared with men who have normal weight, those who are overweight (BMI more than 25 kg/sq m) have about 50% greater risk, and obese men (BMI more than 30 kg/sq m) are more than twice likely to develop liver disease and liver cancer in later life.

An earlier study involving nearly 50,000 men showed that there was an association between high BMI at an early age and increased risk of end-stage liver disease. It was based on data collected in 1969-70, when being overweight and obese were relatively uncommon, so the study was not statistically powered to confirm an association between high BMI and increased risk of end-stage liver disease.

But the latest study found that people who have higher BMI even at an early age are at higher risk of developing severe liver disease as the “duration of being exposed to a high BMI” increases the risk. The greatest risk was for those with BMI greater than 30 kg/sq m. The non-alcoholic fatty liver disease is likely to be the “main driver” of severe liver disease in adolescent men, the study says.

Alcohol consumption and smoking were taken into account and those who had developed alcoholic liver disease were excluded from the final analysis. This did not change the overall finding. But the risk of severe liver disease was “highly affected” by development of type 2 diabetes during follow-up across all BMI categories.

People with high BMI are at increased risk of developing diabetes, which in turn is associated with heightened risk of developing severe liver disease. Yet, increased risk of severe liver disease was seen even in overweight men who did not have diabetes. Therefore, even if the risk is increased in overweight and obese men who develop diabetes, the association of high BMI at an early age and severe liver disease at a later date “cannot solely be explained” by type 2 diabetes, the study says.

The takeaway: there should be targeted intervention to prevent diabetes and more than normal BMI at an early age.

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