The DOI matches its Crossref record; 23 of the 23 references it cites were found in a registry or an index.
Body mass index and risk of liver cirrhosis in middle aged UK women: prospective study
Open accessAbstract
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. 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]
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Nonalcoholic Fatty Liver Disease
Angulo, P. (2002) · New England Journal of Medicine · doi:10.1056/nejmra011775 · Cited by 5,228
Prospective Studies Collaboration (2009) · The Lancet · doi:10.1016/s0140-6736(09)60318-4 · Cited by 4,807
Blood pressure, stroke, and coronary heart disease
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Nonalcoholic Fatty Liver Disease: From Steatosis to Cirrhosis
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Nonalcoholic fatty liver disease
Adams, L. A. (2005) · Canadian Medical Association Journal · doi:10.1503/cmaj.045232 · Cited by 1,658
Health and Deprivation: Inequality and the North
Townsend, P. D., Phillimore, P., & Beattie, A. (1987) · DOAJ (DOAJ: Directory of Open Access Journals) · Cited by 1,473
Diabetes increases the risk of chronic liver disease and hepatocellular carcinoma
El‐Serag, H. B., Tran, T., & Everhart, J. E. (2004) · Gastroenterology · doi:10.1053/j.gastro.2003.10.065 · Cited by 1,242
Validity of self-reported height and weight in 4808 EPIC–Oxford participants
Spencer, E. A., Appleby, P. N., Davey, G. K., & Key, T. J. (2002) · Public Health Nutrition · doi:10.1079/phn2001322 · Cited by 1,082
Health and Deprivation: Inequality and the North
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Rønn, J. H., Jepsen, P., Mellinger, J. L., Innes, H. A., Eliasen, M., Christensen, A. I., Madsen, L. G., & Askgaard, G. (2026) · Journal of Hepatology · doi:10.1016/j.jhep.2026.08.017
Impact of Magnetic Resonance Elastography on Liver Diseases: Clinical Perspectives
Asrani, S. K., & Talwalkar, J. A. (2014) · Springer eBooks · doi:10.1007/978-1-4939-1575-0_6
Metadata
- 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.
- 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
- 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
- hybrid
- doi.org
- 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 › Hepatology › 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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