Elevated body mass index is a risk factor associated with possible liver cirrhosis across different etiologies of chronic liver disease

Background/Purpose Metabolic risk factors are associated with liver fibrosis. Whether or not metabolic risk factors affect the severity of liver fibrosis in patients with chronic hepatitis B (CHB), chronic hepatitis C (CHC), or risk factors associated with non-alcoholic fatty liver disease (NAFLD) remains unclear. We aimed to investigate this by transient elastography. Methods In this cross-sectional study, we enrolled 1513 patients who presented with chronic liver disease (CLD) at a tertiary hospital. Liver stiffness measurement (LSM) >13 kPa was used as a cutoff suggesting possible liver cirrhosis (LC). Results Possible LC was noted in 7.8% of the CHB patients, 19.9% of the CHC patients, and 11.9% of the patients with risk factors associated with NAFLD. After adjustments for biochemical and virological factors were made, BMI (per 1 kg/m 2 increase) (OR: 1.17, 95% CI: 1.06–1.29, P = 0.002) was found to be an independent factor associated with possible LC in CHB patients; BMI (per 1 kg/m 2 increase) (OR: 1.15, 95% CI: 1.07–1.24, P < 0.001) and diabetes mellitus (DM) (OR: 2.32, 95% CI: 1.25–4.30, P = 0.008) were found to be independent factors associated with possible LC in CHC patients; and BMI (per 1 kg/m 2 increase) (OR: 1.19, 95% CI: 1.07–1.32, P = 0.002) and DM (OR: 10.35, 95% CI: 2.95–36.32, P < 0.001) were found to be independent factors associated with possible LC in patients with risk factors associated with NAFLD. Conclusion Elevated BMI was an independent risk factor associated with possible LC across the three different etiologies of CLD. As such, weight loss may be beneficial in these patients.