Weight History influences the Development of Cirrhosis in Chronic Liver Disease

Purpose: Weight and lifestyle play important roles in the development of many diseases. The aim of this study is to evaluate weight and lifestyle in the development of cirrhosis in the setting of chronic liver disease. Methods: Using the Weight and Lifestyle Instrument and clinical variables, collected on consecutive patients at the Penn State Hershey Medical Center a data base was created. Univariate and Multivariate analysis was performed. Results: A total of sixty-six patients did not have cirrhosis (non-cirrhosis) and 28 had cirrhosis. Obesity was similar between cirrhosis and non-cirrhosis. The time spent with BMI >30 was greater in cirrhosis then in non-cirrhosis (19.1 vs. 11.4 years). In the cirrhosis group 61% were obese for more than 15 years whereas in the non-cirrhosis group only 33% (P=0.01). The cirrhosis cases showed a pattern of lifetime gaining or shifting weights more often than non-cirrhosis (p=0.01), more often gained or lost a total of 80 pounds in their lifetime (p=0.005) and more often showed any form of weight shifting (p=0.02). In the final model the variables that predicted cirrhosis were platelet count, alcohol use of at least 20 grams daily and the time in years spent obese. Conclusion: These findings suggest that patients with liver disease should be counseled to remain lean (BMI <30). When patients with liver disease are overweight they should be counseled to lose weight and then maintain the lower weight. Patients with chronic liver disease need to be counseled against weight shifts.Table: Logistic regression model: independent predictors of cirrhosisTable: Odds of cirrhosis as time spent obese with chronic liver disease