Obesity and Its Correlation With Severe Alcoholic Hepatitis

Abstract

Introduction: The prevalence of obesity in the United State has been rising in the last two decades. While the association of obesity with alcohol-associated liver disease and cirrhosis is recognized, little is known about possible correlations between severe alcohol hepatitis(AH) and obesity. In contrast to obesity, underweight MBI and its correlation with alcoholic hepatitis is not studied yet. Our aim in this study is to examine whether obesity defined by different body mass index (BMI) groups is associated with the severity of AH and to assess potential correlations between mortality and BMI in those who develop severe AH. Our second aim was to explore correlations between underweight and severe AH. Methods: We performed a single center, retrospective chart review study of patients, between the ages 18 and 80 with AH from January 2008 to January 2018. AH was defined as recent alcohol consumption with elevations in the AST and ALT levels (ratio >1.5), bilirubin level >3 mg/dL and no other causes of liver injury or chronic liver disease. Obesity was classified based on BMI into class I: BMI 30-34.99, class II:35-39.99 and class III: 40 and above. Underweight was defined by BMI < 20. Results: Three hundred and sixty one patients met the criteria of AH, the mean age was 47.6 +/- 10.4 years. Male gender was predominant (65%), while Caucasians represented 92% of the cohort. The mean Maddrey discriminant function(MDF) and MELD scores were 44.4 +/- 42.0 and 22.5 +/- 8.0, respectively. Severe AH, based on MDF ≥32, was found in 198 patients representing 55% of the cohort. Among obese patients, BMI 35-39.9 was associated with severe AH with an odd ratio 2.2 and P-value 0.04. We found an association between BMI and mortality in severe AH. BMI 35-39.9 was associated with higher mortality rate when compared to other BMI groups with an odd ratio of 3.6 and P=Value of 0.004. When compared with moderate AH, (Maddrey Conclusion: Patients with BMI 35-39.9 are more likely to present with severe AH compared to other BMI groups. BMI 35-39.9 correlates with death in severe AH. These data indicate that obesity is a risk factor for severe disease and poor outcome in AH.906 Figure 1 No Caption available.