Obese women who consume moderate amounts of alcohol have a risk of developing cirrhosis nearly twice that of normal-weight women who drink the same amount, and obesity and heavy alcohol consumption act in concert to increase deaths from liver disease in men, according to two studies.
“In combination with moderate alcohol consumption, obesity substantially increases the likelihood of liver cirrhosis,” Bette Liu, Ph.D., lead author of the first study, said in a prepared statement.
Dr. Liu and her colleagues at the University of Oxford's Cancer Epidemiology Unit—with funding from Cancer Research UK, the National Health Service, and the Medical Research Council—analyzed data from a cohort of 1,230,662 U.K. women, recruited between 1996 and 2001, with a mean age of 56. All had been screened for prior liver disease or cancer, though a fifth were current smokers and 2.4% had been treated for diabetes. A total of 46% of women in the study were considered to be of healthy weight or underweight (with a body mass index of less than 25 kg/m10.1136/bmj.c912
Over a mean follow-up of 6.2 years, 1,811 women had a first cirrhosis-related hospital admission or death, and 421 of these women had cirrhosis recorded for the first time at death.
Of middle-aged women of normal weight (a BMI of between 22.5 and 25) who drank less than 70 g of alcohol per week (a mean of less than half a drink per day), 0.8 in 1,000 risked being hospitalized with or dying from cirrhosis over 5 years, compared with 1 in 1,000 for obese women with light drinking habits. When the drinks increased, however, the risk profile was magnified across all weight categories, and the risk contrast between normal-weight and obese women became starker.
Normal-weight women who consumed at least 150 g of alcohol per week (a mean of about two and a half alcoholic drinks a day) carried a risk of 2.7 in 1,000 of being hospitalized for or dying from cirrhosis within 5 years, the researchers found, with a 28% increase for each 5-unit increase in BMI above 22.5. For obese women, the risk increased to 5 in 1,000.
In the second study, funded by the Scottish government, Carole L. Hart, Ph.D., of the University of Glasgow and colleagues analyzed links among obesity, liver disease, and alcohol in 9,559 Scottish men, many of whom did report heavy drinking and just under half of whom were overweight or obese (42% and 6%, respectively). The men in the analysis had been recruited at varying ages (mean 47 years) in the 1960s and 1970s for two long-term cohort studies, which tracked their health data for an average of 29 years (BMJ 2010;340:c1240 doi:10.1136/bmj.c1240
Eighty men died with liver disease as the main cause of death, and 146 died with liver disease mentioned in any of the causes of death.
Obese men who reported drinking at least 15 units of alcohol per week had a relative rate of developing liver disease nearly double that of obese men who drank between 14 or fewer units per week (9.73 vs 4.50, after adjustment).
Neither Dr. Liu's nor Dr. Hart's teams declared any conflicts of interest.