TY - JOUR
T1 - Waist/hip ratio better predicts development of severe liver disease within 20 years than body mass index
T2 - a population-based cohort study
AU - Andreasson, Anna
AU - Carlsson, Axel C.
AU - Önnerhag, Kristina
AU - Hagström, Hannes
N1 - Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.
PY - 2017/8/1
Y1 - 2017/8/1
N2 - Background & aims: Obesity, commonly assessed based on body mass index (BMI), is associated with an increased risk for severe liver disease. It is not known if other measures of body composition are better determinants of risk for severe liver disease, and or if these differ between women and men. We investigated the body composition measures that best predict the development of severe liver disease.Methods: We collected data from the Malmö Diet and Cancer study in Sweden, comprising 16,784 women and 10,833 (mean age, 58.1 years at baseline), and followed patients for a median 19.8 years. We analyzed data on measures of body composition including BMI, waist:hip ratio, and others. We determined whether subjects were diagnosed with severe liver disease, or died from severe liver disease, until the end of 2014 using Swedish national registers. Associations between body composition measures and severe liver disease were assessed using Cox regression models, stratified by sex and adjusted for age, alcohol consumption, smoking, education and physical activity.Results: All studied measures of body composition were significantly associated with severe liver disease. Waist:hip ratio was the best predictor of severe liver disease in women (hazard ratio (HR) per standard deviation [SD] increment, 1.30; 95% CI, 1.16-1.46) and men (HR, 1.46; 95% CI, 1.31-1.63). BMI had the lowest HR in women (HR, 1.12; 95% CI, 1.00-1.27) and men (HR, 1.26; 95% CI, 1.12-1.42). The association between waist:hip ratio and development of liver disease was independent of BMI.Conclusions: In a Swedish population-based cohort study, we associated all measures of body composition with risk of severe liver disease. However, measures of abdominal obesity were best at predicting development of severe liver disease.
AB - Background & aims: Obesity, commonly assessed based on body mass index (BMI), is associated with an increased risk for severe liver disease. It is not known if other measures of body composition are better determinants of risk for severe liver disease, and or if these differ between women and men. We investigated the body composition measures that best predict the development of severe liver disease.Methods: We collected data from the Malmö Diet and Cancer study in Sweden, comprising 16,784 women and 10,833 (mean age, 58.1 years at baseline), and followed patients for a median 19.8 years. We analyzed data on measures of body composition including BMI, waist:hip ratio, and others. We determined whether subjects were diagnosed with severe liver disease, or died from severe liver disease, until the end of 2014 using Swedish national registers. Associations between body composition measures and severe liver disease were assessed using Cox regression models, stratified by sex and adjusted for age, alcohol consumption, smoking, education and physical activity.Results: All studied measures of body composition were significantly associated with severe liver disease. Waist:hip ratio was the best predictor of severe liver disease in women (hazard ratio (HR) per standard deviation [SD] increment, 1.30; 95% CI, 1.16-1.46) and men (HR, 1.46; 95% CI, 1.31-1.63). BMI had the lowest HR in women (HR, 1.12; 95% CI, 1.00-1.27) and men (HR, 1.26; 95% CI, 1.12-1.42). The association between waist:hip ratio and development of liver disease was independent of BMI.Conclusions: In a Swedish population-based cohort study, we associated all measures of body composition with risk of severe liver disease. However, measures of abdominal obesity were best at predicting development of severe liver disease.
KW - cirrhosis
KW - overweight
KW - body weight
KW - waist size
UR - http://www.scopus.com/inward/record.url?scp=85030485247&partnerID=8YFLogxK
U2 - 10.1016/j.cgh.2017.02.040
DO - 10.1016/j.cgh.2017.02.040
M3 - Article
C2 - 28342948
SN - 1542-3565
VL - 15
SP - 1294-1301.e2
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
IS - 8
ER -