Overweight in late adolescence predicts development of severe liver disease later in life: A 39years follow-up study.
The increased prevalence of overweight has been suggested to contribute to the worldwide increase in liver diseases. We investigated if body mass index (BMI) in late adolescence predicts development of severe liver disease later in life.



We performed a cohort study using data from 44,248 men (18-20years) conscribed to military service in Sweden between 1969 and 1970. Outcome data were collected from national registers to identify any diagnosis of severe liver disease (i.e., diagnosis of decompensated liver disease, cirrhosis or death in liver disease) until the end of 2009. A Cox regression model was applied using BMI as independent variable. The model was adjusted for use of alcohol, use of narcotics, smoking, high blood pressure and cognitive ability at time of conscription.



During a follow-up period of a mean of 37.8years, 393 men were diagnosed with severe liver disease (mean time to diagnosis 24.7years). BMI (Hazard ratio [HR]=1.05 for each unit increase in BMI, 95% confidence interval [CI]: 1.01-1.09, p=0.008) and overweight (HR=1.64 for BMI 25-30 compared to BMI 18.5-22.5, 95% CI: 1.16-2.32, p=0.006) were associated with an increased risk of development of severe liver disease.



Being overweight in late adolescence is a significant predictor of severe liver disease later in life in men.



We investigated close to 45,000 Swedish men in their late teens enlisted for conscription in 1969-1970. After almost 40years of follow-up, we found that being overweight was a risk factor for developing severe liver disease, independent of established risk factors such as alcohol consumption.
Centre for Digestive Diseases, Division of Hepatology, Karolinska University Hospital, Stockholm, Sweden; Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden. Electronic address: hannes.hagstrom@ki.se.
Hannes
H
Hagström
Centre for Digestive Diseases, Division of Hepatology, Karolinska University Hospital, Stockholm, Sweden; Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden.
Per
P
Stål
Centre for Digestive Diseases, Division of Hepatology, Karolinska University Hospital, Stockholm, Sweden; Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden.
Rolf
R
Hultcrantz
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden.
Tomas
T
Hemmingsson
Stress Research Institute, Stockholm University, Stockholm, Sweden; Division of Family Medicine, Department of Neurobiology, Care sciences and Society, Karolinska Institutet, Huddinge, Sweden.
Anna
A
Andreasson
D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D005500:Follow-Up Studies; D006801:Humans; D008107:Liver Diseases; D008297:Male; D050177:Overweight; D012307:Risk Factors; D013548:Sweden; D055815:Young Adult
Body mass index; Cirrhosis; Decompensated liver disease; Epidemiology; Long-term follow-up