ReviewJournal of clinical and translational hepatology2019
Obesity Paradox in Chronic Liver Diseases: Product of Bias or a Real Thing?
Review in Journal of clinical and translational hepatology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 28 citations in OpenAlex.
- MASLD In PBC: A Shift From Liver-Centred to Cardiometabolic Risk Assessment?Liver international : official journal of the International Association for the Study of the Liver · 2026Article
- Reduced visceral adipose tissue area linked to early recurrence in HCC patients with HBV: a parallel mediation analysis.Abdominal radiology (New York) · 2026Article
- Interrelationships Between Key Cardiovascular Risk Factors, Chronic Kidney Disease and Metabolic Dysfunction-Associated Steatotic Liver Disease.Current cardiology reports · 2026Review
- Association between weight-adjusted waist index and hepatic steatosis and fibrosis: Analyses of the NHANES 2017 to 2020.Medicine · 2025Article
- Differential prevalence and prognostic value of metabolic syndrome components among patients with MASLD.JHEP reports : innovation in hepatology · 2024Article
- Liver at crossroads: unraveling the links between obesity, chronic liver diseases, and the mysterious obesity paradox.Clinical and experimental medicine · 2024Review
- Mortality outcomes in diabetic metabolic dysfunction-associated fatty liver disease: non-obese versus obese individuals.Scientific reports · 2024Article
- Association between weight-adjusted waist index and non-alcoholic fatty liver disease: a population-based study.BMC endocrine disorders · 2024Article
- The causes of death in patients with nonalcoholic steatohepatitis following liver transplantation stratified using pre-liver transplant BMI.Hepatology international · 2023Article
- Longitudinal Study of Comorbidities and Clinical Outcomes in Persons with Gallstone Disease Using Electronic Health Records.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Article
- Body mass index and risk of all-cause mortality among elderly Chinese: An empirical cohort study based on CLHLS data.Preventive medicine reports · 2023Article
- Association between obesity and short- and medium-term mortality in critically ill patients with atrial fibrillation: a retrospective cohort study.BMC cardiovascular disorders · 2023Article
- Cardiovascular Risk Is Elevated in Lean Subjects with Nonalcoholic Fatty Liver Disease.Gut and liver · 2022Article
- Association of liver fibrosis biomarkers with overall and CVD mortality in the Korean population: The Dong-gu study.PloS one · 2022Article
- Shifting perspectives - interplay between non-alcoholic fatty liver disease and insulin resistance in lean individuals.World journal of hepatology · 2021Review
- The Repeatedly Elevated Fatty Liver Index Is Associated With Increased Mortality: A Population-Based Cohort Study.Frontiers in endocrinology · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
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.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.