Obesity is the most common risk factor for chronic liver disease: Results from risk stratification pathway using transient elastography

Harris, Rebecca; Card, Timothy R; Delahooke, Toby; Aithal, Guruprasad P; Guha, Indra N

Abstract

Introduction
Obesity has been associated with liver fibrosis yet guidelines do not emphasise it as an independent risk factor in which to have a high index of suspicion of advanced disease. We aimed to elucidate the effect of a raised body mass index on the risk of liver disease using data from a community risk stratification pathway.
Methods
We prospectively recruited patients from a primary care practice with hazardous alcohol use and/or type 2 diabetes and/or obesity. Subjects were invited for a transient elastography reading. A threshold of ?8.0kPa defined an elevated reading consistent with clinically significant liver disease.
Results
Five hundred and seventy six patients participated in the pathway of which, 533 patients had a reliable reading and 66 (12.4%) had an elevated reading. Thirty one percent of patients with an elevated reading had obesity as their only risk factor. The proportion of patients with an elevated reading was similar among those with obesity (8.9%) to patients with more recognised solitary risk factors (Type 2 diabetes 10.8%; Hazardous alcohol use 4.8%). Obesity in combination with other risk factors further increased the proportion of patients with an elevated reading. In multivariate logistic regression, increasing BMI and type 2 diabetes were significantly associated with an elevated reading.
Conclusion
Obesity as a single or additive risk factor for chronic liver disease is significant. Future case finding strategies using a risk factor approach should incorporate obesity within proposed algorithms.

Citation

Harris, R., Card, T. R., Delahooke, T., Aithal, G. P., & Guha, I. N. (2019). Obesity is the most common risk factor for chronic liver disease: Results from risk stratification pathway using transient elastography. American Journal of Gastroenterology, 114(11), 1744-1752. https://doi.org/10.14309/ajg.0000000000000357

• Journal Article Type: Article
• Acceptance Date: Jul 10, 2019
• Online Publication Date: Aug 27, 2019
• Publication Date: 2019-11
• Deposit Date: Jul 22, 2019
• Publicly Available Date: Sep 4, 2019
• Journal: The American Journal of Gastroenterology
• Print ISSN: 0002-9270
• Electronic ISSN: 1572-0241
• Publisher: Nature Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 114
• Issue: 11
• Pages: 1744-1752
• DOI: https://doi.org/10.14309/ajg.0000000000000357
• Keywords: Screening, transient elastography, Non-alcoholic fatty liver disease, Community, Body Mass Index
• Public URL: https://nottingham-repository.worktribe.com/output/2328935
• Publisher URL: https://journals.lww.com/ajg/Abstract/2019/11000/Obesity_Is_the_Most_Common_Risk_Factor_for_Chronic.13.aspx