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Higher BMI Predicts Clinical Decompensation in Cirrhosis

Significantly increased risk for patients with compensated cirrhosis who have elevated BMI

TUESDAY, July 26 (HealthDay News) -- Higher body mass index (BMI) is a significant predictor of clinical decompensation (CD) in patients with compensated cirrhosis, independent of other previously described predictors and treatment groups, according to a study published online June 26 in Hepatology.

Annalisa Berzigotti, M.D., Ph.D., from the Hospital Clinic in Barcelona, Spain, and colleagues examined the role of obesity in the development of CD in 161 patients with compensated cirrhosis. The patients were part of a randomized trial of beta blockers in the prevention of varices. Portal pressure, evaluated by hepatic venous pressure gradient (HVPG), and laboratory tests were carried out. Follow-up was carried out for an average of 59 months until CD (encephalopathy, ascites, hepatic or variceal hemorrhage) or until September 2002.

The investigators found that 40 percent of patients were overweight and 30 percent were obese. During the follow-up period, CD occurred in 30 percent of all participants, with an increasingly higher rate with increasing BMI (15, 31, and 43 percent in normal, overweight, and obese groups, respectively). Patients in the abnormal BMI groups had a significantly higher actuarial probability of developing CD. BMI was an independent predictor of CD (hazard ratio, 1.06; 95 percent confidence interval, 1.01 to 1.12), along with HVPG and albumin, in a model that included parameters previously identified as being predictive of CD (HVPG, albumin, Mayo end-stage liver disease score), etiology, and treatment group.

"Obesity has a deleterious effect on the natural history of compensated cirrhosis of all etiologies, independent of portal pressure and liver function. Weight reduction may be a valuable therapeutic measure in this patient population," the authors write.

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