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 If the young men also had type 2 diabetes, their risk of having
liver disease by the time they reached middle age was as much as 3.3
times higher, researchers report in the journal Gut.
Past studies have shown that diabetes raises risk for liver disease
and liver cancer, but the current study indicates that having a high
body mass index (BMI), a measure of weight relative to height, is a
risk factor on its own.
“A high BMI early in life in men is associated with an increased
risk of developing severe liver disease later in life, and this
cannot be explained by a high alcohol consumption or viral
hepatitis,” lead study author Dr. Hannes Hagstrom told Reuters
Health by email.
"Also, this risk was highly increased in those men who contracted
type 2 diabetes during the follow-up, independent of the baseline
BMI,” said Hagstrom, a researcher with the Center for Digestive
Diseases at Karolinska University Hospital in Stockholm.
The study team analyzed records for 1,220,261 men who had physicals
when they were drafted into the Swedish army between 1969 and 1996
and were 17 to 19 years old at the time. Using national health
registries, the researchers followed the men until 2012.
They grouped men according to BMI, which is measured as kilograms
per square meter. Normally, a BMI between 18.5 and 24.9 is
considered a healthy weight, while 25 to 29.9 is overweight, 30 or
above is obese and 40 or higher is what's known as morbidly obese.
In the current study, researchers reduced the healthy range to BMIs
between 18.5 and 22.5, and used men in that group as the basis for
comparisons with all the others.
When the men were drafted, the average BMI was 21.5, and just
100,000 men were in the overweight range and 20,000 qualified as
obese. But rates of obesity differed across the original enlistment
period, the researchers note. In 1969, about 6 percent of men were
overweight and less than 1 percent were obese, but by 1996, 12
percent of young men were overweight and almost 3 percent were
obese.
Over the follow-up period, 5,281 men developed severe liver
diseases, including cirrhosis and liver failure, and 251 were
diagnosed with liver cancer.
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When compared to men with BMIs less than 22.5 at baseline, the risk
of severe liver disease increased as BMIs went up: men in the
overweight category had about 50 percent increased risk of liver
disease and obese men had a two-fold increased risk. Excluding men
with a diagnosis of alcoholic liver disease from the analysis raised
the risk associated with obesity slightly higher still.
"Although we cannot know for sure, we speculate that these men had
or developed non-alcoholic fatty liver disease, and that this in
some cases led to severe liver disease,” Hagstrom said.
When they looked at liver cancer, the researchers found that men who
were overweight at baseline had about a 60 percent increase in risk,
while the risk was more than tripled for men who were obese.
Hagstrom said physicians should know overweight and obese teenage
boys are at an increased risk for future severe liver disease, and
that intervention early in life likely is necessary to reduce this
risk.
“Obesity is an important risk factor for a number of types of
cancer. Liver cancer is one of those,” Karen Basen-Engquist told
Reuters Health.
“This study shows that even obesity in early adulthood is associated
with later risk. It's important for us to try to maintain a healthy
weight all through our lives,” said Basen-Engquist, director of the
University of Texas MD Anderson’s Center for Energy Balance in
Cancer Prevention and Survivorship in Houston.
Basen-Engquist, who was not involved in the study, said doctors and
researchers need to keep getting that message out because a lot of
people aren't aware of the link between obesity and cancer. “A lot
of people know about smoking and cancer, but they don't think about
obesity and cancer risk.”
SOURCE: http://bit.ly/2nYYC0X Gut, online March 20, 2017.
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