Elevated body mass index is a risk factor associated with possible liver cirrhosis across different etiologies of chronic liver disease

Abstract

Background/purpose: Metabolic risk factors are associated with liver fibrosis. Whether or not metabolic risk factors affect the severity of liver fibrosis in patients with chronic hepatitis B (CHB), chronic hepatitis C (CHC), or risk factors associated with non-alcoholic fatty liver disease (NAFLD) remains unclear. We aimed to investigate this by transient elastography.

Methods: In this cross-sectional study, we enrolled 1513 patients who presented with chronic liver disease (CLD) at a tertiary hospital. Liver stiffness measurement (LSM) >13 kPa was used as a cutoff suggesting possible liver cirrhosis (LC).

Results: Possible LC was noted in 7.8% of the CHB patients, 19.9% of the CHC patients, and 11.9% of the patients with risk factors associated with NAFLD. After adjustments for biochemical and virological factors were made, BMI (per 1 kg/m² increase) (OR: 1.17, 95% CI: 1.06-1.29, P = 0.002) was found to be an independent factor associated with possible LC in CHB patients; BMI (per 1 kg/m² increase) (OR: 1.15, 95% CI: 1.07-1.24, P < 0.001) and diabetes mellitus (DM) (OR: 2.32, 95% CI: 1.25-4.30, P = 0.008) were found to be independent factors associated with possible LC in CHC patients; and BMI (per 1 kg/m² increase) (OR: 1.19, 95% CI: 1.07-1.32, P = 0.002) and DM (OR: 10.35, 95% CI: 2.95-36.32, P < 0.001) were found to be independent factors associated with possible LC in patients with risk factors associated with NAFLD.

Conclusion: Elevated BMI was an independent risk factor associated with possible LC across the three different etiologies of CLD. As such, weight loss may be beneficial in these patients.

Keywords: Liver cirrhosis; Liver stiffness measurement; Metabolic risk factor.