Journal of Clinical and Translational Hepatology

Journal of Clinical and Translational Hepatology

Saturday, 11 / 16 / 2019

Articles

Obesity Paradox in Chronic Liver Diseases: Product of Bias or a Real Thing?

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Obesity Paradox in Chronic Liver Diseases: Product of Bias or a Real Thing?

Ines Bilic Curcic1,2, Maja Cigrovski Berkovic3, Lucija Kuna4, Hrvoje Roguljic1,5, Robert Smolic6,7, Silvija Canecki Varzic2,8, Lucija Virovic Jukic9 and Martina Smolic*1,4

1Department of Pharmacology, Faculty of Medicine, J. J. Strossmayer University of Osijek, Osijek, Croatia
2Department of Diabetes, Endocrinology and Metabolism Disorders, Osijek University Hospital Centre, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
3Department for Endocrinology, Diabetes and Metabolism University Hospital Center, “Sestre Milosrdnice”, Zagreb, Croatia
4Department of Pharmacology and Biochemistry, Faculty of Dental Medicine and Health, J. J. Strossmayer University of Osijek, Osijek, Croatia
5Department for Cardiovascular Disease, Osijek University Hospital, Osijek, Croatia
6Department of Gastroenterology and Hepatology, Osijek University Hospital Centre, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
7Department of Pathophysiology, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
8Department of Internal Medicine, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
9Department of Gastroenterology and Hepatology, Sisters of Mercy University Hospital, University of Zagreb School of Medicine, Zagreb, Croatia
*Correspondence to: Martina Smolic, Department of Pharmacology, J. J. Strossmayer University of Osijek Faculty of Medicine Osijek, J. Huttlera 4, Osijek 31000, Croatia. Tel: + 385-31-512-800, Fax: +385-31-512-833, E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Journal of Clinical and Translational Hepatology 2019;7(3):275-279 DOI: 10.14218/JCTH.2019.00029
Received: July 11, 2019 Accepted: September 9, 2019 Published online: September 15, 2019

Abstract

In recent years, evidence supporting the theory of obesity paradox has increased, showing that obese/overweight people with prevalent chronic diseases experience lower mortality compared with patients of normal weight. So far, evidence is most comprehensive in cardiovascular and chronic renal diseases; however, published studies are prone to many biases, enabling us to reach a definite conclusion. Available data in chronic liver disease is scarce and ambiguous. Obesity is traditionally associated with nonalcoholic fatty liver disease and steatosis in viral hepatitis and as such one would not expect the obesity paradox to be a real possibility in liver disease. Yet, there seem to be new data indicating the opposite – the obesity paradox exists in severe and end-stage liver cirrhosis, which could be attributed to a better lean mass in patients with higher body mass index, meaning that sarcopenia, as one of the most important prognostic factors of survival, is less likely to be present. Nonetheless, the problem of various methodological problems addressing the association between body weight and mortality, which is present both in liver disease and other chronic diseases, are preventing us from attaining an unanimous conclusion. Still, we should be aware that the obesity paradox might be true, especially in severe and end-stage illness. This suggests focusing our efforts toward preserving or building up fat-free mass and decreasing inflammatory activity responsible for catabolism and sarcopenia, and implying that the underlaying cause should be treated.

Keywords

Obesity paradox, Chronic liver disease, NAFLD, NASH, Cirrhosis

 

Journal of Clinical and Translational Hepatology 2019 vol. 7, 275-279  [ Html ] [ PDF Full-text ]

© The Authors 2019. This article is published under the terms of the Creative Commons Attribution-Noncommercial License (CC BY-NC 4.0), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.

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