Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2021 Jun;41(6):1216-1226.
doi: 10.1111/liv.14754. Epub 2020 Dec 22.

The combined effect of alcohol and body mass index on risk of chronic liver disease: A systematic review and meta-analysis of cohort studies

Kate Glyn-Owen  1 , Dankmar Böhning  2 , Julie Parkes  1 , Paul Roderick  1 , Ryan Buchanan  1
Affiliations
Meta-Analysis

The combined effect of alcohol and body mass index on risk of chronic liver disease: A systematic review and meta-analysis of cohort studies

Kate Glyn-Owen et al. Liver Int. 2021 Jun.

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.

Keywords: alcohol; chronic liver disease; cirrhosis; meta-analysis; obesity.

PubMed Disclaimer

References

REFERENCES

    1. World Health Organisation. Disease burden and mortality estimates: cause specific mortality 2000-2016. Geneva, 2018.
    1. Williams R, Aspinall R, Bellis M, et al. Addressing liver disease in the UK: a blueprint for attaining excellence in health care and reducing premature mortality from lifestyle issues of excess consumption of alcohol, obesity, and viral hepatitis. Lancet. 2014;384:1953-1997.
    1. Pimpin L, Cortez-Pinto H, Negro F, et al. Burden of liver disease in Europe: Epidemiology and analysis of risk factors to identify prevention policies. J Hepatol. 2018;69(3):718-735.
    1. Foundation for liver research. Financial case for action on liver disease. In: Lancet Commission on Liver Disease. London, 2017.
    1. Younossi Z, Koenig A, Abdelatif D, et al. Global epidemiology of non-alcoholic fatty liver disease - meta-analytic assessment of prevalence. Incidence and Outcomes. Hepatol. 2016;64(1):73-84.

Publication types

LinkOut - more resources