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Obesity associated with rapid fibrosis progression in patients with primary sclerosing cholangitis
BOSTON — Obese patients with primary sclerosing cholangitis had more advanced fibrosis at presentation and more rapid progression of fibrosis compared with overweight and normal-weight patients, according to data presented at The Liver Meeting.
“The take-home point from our study is that increased BMI in patients with primary sclerosing cholangitis can precipitate cirrhosis and lead to worse outcomes in patients,” Aliya Gulamhusein, research fellow at the Mayo Clinic, said in an interview. “Obese patients do worse generally and their fibrosis can progress quicker than patients who do not have an elevated BMI.”
As a high proportion of patients with primary sclerosing cholangitis (PSC) are overweight or obese, Gulamhusein and colleagues evaluated the effect of BMI on fibrosis stage and progression in 247 patients (1,368 patient-years of follow-up) recruited from the Calgary PSC cohort. Patients were classified as normal (BMI <25 kg/m2; n=176), overweight (25 to 30 kg/m2; n=57) or obese (>30 kg/m2; n=14), and fibrosis stage was classified as F0 to F4 based on annual measurements using noninvasive transient elastography.
The mean progression time to next fibrosis stage was 51 months for normal-weight patients, 47 months for overweight patients and 13 months for obese patients. Patients classified as obese also presented with a more advanced fibrosis stage compared with patients classified as overweight or normal weight.
Obesity in patients with PSC is therefore associated with more fibrosis at presentation as well as more rapid progression of fibrosis, the researchers concluded. – by Adam Leitenberger
For more information:
Gulamhusein A. Abstract 283. Presented at: The Liver Meeting; Nov. 7-11, 2014; Boston.
Disclosure: Gulamhusein reports no relevant financial disclosures.