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Cited by 202Alcohol Consumption and Health EffectsLiver Disease Diagnosis and TreatmentLiver Disease and Transplantation

Body mass index and risk of liver cirrhosis in middle aged UK women: prospective study

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Liu, B., Balkwill, A., Reeves, G., Beral, V., on behalf of the Million Women Study Collaborators.·2010·BMJ
DOI 10.1136/bmj.c912PMC PMC2837146
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Abstract

OBJECTIVE: To determine the relation between body mass index (BMI) and liver cirrhosis and the contribution that BMI and alcohol consumption make to the incidence of liver cirrhosis in middle aged women in the UK. DESIGN: Prospective cohort study (Million Women Study). SETTING: Women recruited from 1996 to 2001 in NHS breast screening centres and followed by record linkage to routinely collected information on hospital admissions and deaths. PARTICIPANTS: 1 230 662 women (mean age 56 years at recruitment) followed for an average of 6.2 years. MAIN OUTCOME MEASURES: Relative risk and absolute risk of first hospital admission with or death from liver cirrhosis adjusted for age, recruitment region, alcohol consumption, smoking, socioeconomic status, and physical activity. RESULTS: 1811 women had a first hospital admission with or died from liver cirrhosis during follow-up. Among women with a BMI of 22.5 or above, increasing BMI was associated with an increased incidence of liver cirrhosis: the adjusted relative risk of cirrhosis increased by 28% (relative risk 1.28, 95% confidence interval 1.19 to 1.38; P<0.001) for every 5 unit increase in BMI. Although the relative increase in the risk of liver cirrhosis per 5 unit increase in BMI did not differ significantly according to the amount of alcohol consumed, the absolute risk did. Among women who reported drinking less than 70 g alcohol per week, the absolute risk of liver cirrhosis per 1000 women over five years was 0.8 (0.7 to 0.9) for those with a BMI between 22.5 and 25 and 1.0 (0.9 to 1.2) for those with a BMI of 30 or more. Among women who reported drinking 150 g alcohol or more per week, the corresponding figures were 2.7 (2.1 to 3.4) and 5.0 (3.8 to 6.6). CONCLUSIONS: Excess body weight increases the incidence of liver cirrhosis. In middle aged women in the UK, an estimated 17% of incident or fatal liver cirrhosis is attributable to excess body weight. This compares with an estimated 42% attributable to alcohol.

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  • In the Million Women Study, the adjusted relative risk of cirrhosis increased by 1.3 for each 5-unit rise in BMI of women followed-up for 6.2 years.

    “In the Million Women Study, the adjusted relative risk of cirrhosis increased by 1.3 for each 5-unit rise in BMI of women followed-up for 6.2 years. 44”

    From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [44]

    The Abstract and Results report an adjusted relative risk of 1.28—approximately 1.3—per 5-unit BMI increase, with a mean follow-up of 6.2 years. But that estimate applies to women with BMI of at least 22.5, a restriction the claim omits; the Results describe a different risk pattern below that threshold. (LLM, conf=0.88)

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Authors
Liu, B., Balkwill, A., Reeves, G., Beral, V., & Collaborators., O. B. O. T. M. W. S.
Affiliations
University of Oxford (GB)
Corresponding author
Liu, B.
ORCID
Venue
BMJ
Publisher
BMJ
Published
2010-03-11
Volume
340
Issue
mar11 1
Pages
c912-c912
ISSN
  • 0007-1447 (ISSN-L)
  • 0959-8138
  • 1468-5833
DOI
10.1136/bmj.c912
PMC
PMC2837146
OpenAlex
W1978589383
Cited by
202
References
23
Citations by year
2026: 3 · 2025: 7 · 2024: 18 · 2023: 7 · 2022: 9 · 2021: 22 · 2020: 23 · 2019: 15 · 2018: 17 · 2017: 15 · 2016: 9 · 2015: 13 · 2014: 9 · 2013: 12 · 2012: 6
FWCI
7.60
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • BMJ (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • HighWire Press Open Archive (submittedVersion)
  • ANU Open Research (Australian National University) (submittedVersion, cc-by-nc)
Funders
  • Cancer Research UK
  • Medical Research Council
Topics
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
  • Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
  • Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
Keywords
body mass index, liver cirrhosis, obesity, alcohol consumption, middle-aged women, attributable risk, overweight, Million Women Study
MeSH terms
Adult, Alcohol Drinking, Epidemiologic Methods, Female, United Kingdom, Humans, Liver Cirrhosis, Middle Aged, Obesity, Body Mass Index, Overweight, Young Adult

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