UK: According to an article published in the Hepatology journal, obesity and alcohol consumption are both independent risk factors for cirrhosis morbidity, but they do not combine supra-additively to affect the cumulative incidence of this condition.
Alcohol consumption and body mass index (BMI) are assumed to interact supra-additively to modulate the risk of cirrhosis, however evidence for this is scarce. As a result, Hamish Innes and colleagues looked into the impact of alcohol and BMI on the incidence of cirrhosis morbidity in the United Kingdom Biobank (UKB) research participants.
The primary outcome was the cumulative incidence of cirrhosis morbidity, which was defined as a first-time cirrhosis hospitalization (with noncirrhosis mortality incorporated as a competing risk). The analysis included all UKB participants who had not previously been admitted to a hospital for cirrhosis. According to BMI, the ratio of the 10-year cumulative incidence among dangerous drinkers versus safe drinkers was calculated. Individuals with obesity and/or harmful alcohol had an elevated cumulative incidence of 10 years when compared to healthy drinkers with a BMI of 20-25.0 kg/m2.
The key findings are as follow:
1. A total of 489,285 UK Biobank participants were included in the study, with an average follow-up of 10.7 person-years.
2. The primary outcome was experienced by 2070 people, resulting in a crude cumulative incidence of 0.36 percent after ten years.
3. If BMI was healthy, the 10-year cumulative incidence for dangerous (1.38%) versus safe (0.16%) drinkers was 8.6 times greater.
4. Obese participants, on the other hand, only had a 3.6-fold increase (1.99% vs. 0.56%).
5. For hazardous drinkers with a healthy BMI, the excess cumulative incidence was 1.22%, 0.40% for obese individuals drinking at safe levels, and 1.83% for obese problematic drinkers (all compared to safe drinkers with a healthy BMI).
In conclusion, alcohol consumption and obesity were found to be independent risk variables for cirrhosis morbidity in this investigation.
Reference:
Innes H, Crooks CJ, Aspinall E, Card TR, Hamill V, Dillon J, Guha NI, Hayes PC, Hutchinson S, West J, Morling JR. Characterizing the risk interplay between alcohol intake and body mass index on cirrhosis morbidity. Hepatology. 2022 Feb;75(2):369-378. doi:10.1002/hep.32123. Epub 2021 Dec 6. PMID: 34453350.