Aflatoxin B(1) exposure increases the risk of cirrhosis and hepatocellular carcinoma in chronic hepatitis B virus carriers.
Aflatoxin B(1) exposure increases the risk of cirrhosis and hepatocellular carcinoma in chronic hepatitis B virus carriers.
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DOI：
10.1002/ijc.30782
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发表时间：
2017-08-15
影响因子：
6.4
通讯作者：
Chen CJ
中科院分区：
文献类型：
--
作者：
Chu YJ;Yang HI;Wu HC;Liu J;Wang LY;Lu SN;Lee MH;Jen CL;You SL;Santella RM;Chen CJ
黄曲霉毒素B1（AFB 1）与慢性B型肝炎病毒（HBV）携带者肝硬化的关系尚无定论。这项病例对照研究嵌套在一个大型社区队列中，旨在评估AFB 1暴露对慢性HBV携带者肝硬化和HCC的影响。在232例肝硬化患者、262例HCC患者和577例对照者中检测了研究开始时的血清AFB 1-白蛋白加合物水平。使用logistic回归估计多变量校正比值比（aOR）和95%置信区间（95%CI）。在所有慢性HBV携带者中，血清AFB 1-白蛋白加合物水平高的参与者从进入研究到诊断为HCC、肝硬化、硬化性HCC和非硬化性HCC的时间间隔均显著短于血清AFB 1-白蛋白加合物水平低/检测不到的参与者（p<0.0001）。对于入组后9年内新诊断的肝硬化（p趋势=0.0001）和肝硬化性HCC（p趋势<0.0001）以及入组后4年内新诊断的非肝硬化性HCC（p趋势=0.021），入组研究时血清AFB 1-白蛋白加合物水平存在显著的剂量-反应关系。肝硬化（p=0.0003）、肝硬化性HCC（p=0.0003）和非肝硬化性HCC（p= 0.0368）中高血清AFB 1-白蛋白加合物水平与不可检测血清AFB 1-白蛋白加合物水平的aOR（95% CI）分别为2.45（1.51-3.98）、5.47（2.20-13.63）和5.39（1.11-26.18）。在肝硬化患者中，血清AFB 1-白蛋白加合物水平与HCC风险之间仍然存在显著的剂量-反应关系（p趋势=0.0291），显示高血清水平与不可检测血清水平的aOR（95%CI）为3.04（1.11-8.30）（p=0.0299）。结论：AFB 1暴露可能以剂量反应方式增加慢性HBV携带者发生肝硬化和HCC的风险。
The relation between aflatoxin B1 (AFB1) and cirrhosis in chronic carriers of hepatitis B virus (HBV) remains inconclusive. This case-control study nested in a large community-based cohort aimed to assess the effect of AFB1 exposure on cirrhosis and HCC in chronic HBV carriers. Serum AFB1-albumin adduct levels at study entry were measured in 232 cirrhosis cases, 262 HCC cases and 577 controls. Multivariate-adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) were estimated using logistic regression. Among all chronic HBV carriers, the time intervals between study entry and diagnosis of HCC, cirrhosis, cirrhotic HCC, and non-cirrhotic HCC were all significantly (p<0.0001) shorter in participants with high serum levels of AFB1-albumin adducts than those with low/undetectable levels. There were significant dose-response relations with serum AFB1-albumin adduct level at study entry for cirrhosis (p-trend=0.0001) and cirrhotic HCC (p-trend<0.0001) newly-diagnosed within 9 years after entry as well as non-cirrhotic HCC (p-trend=0.021) newly-diagnosed within 4 years after entry. The aORs (95% CIs) for high vs. undetectable serum AFB1-albumin adduct levels were 2.45 (1.51–3.98) for cirrhosis (p=0.0003), 5.47 (2.20–13.63) for cirrhotic HCC (p=0.0003), and 5.39 (1.11–26.18) for non-cirrhotic (p=0.0368) HCC, respectively. There remained a significant dose-response relation between serum AFB1-albumin adduct level and HCC risk (p-trend=0.0291) in cirrhosis patients, showing an aOR (95% CI) of 3.04 (1.11–8.30) for high vs. undetectable serum levels (p=0.0299). It is concluded that AFB1 exposure may increase the risk of cirrhosis and HCC in a dose-response manner among chronic HBV carriers.
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影响因子：
10.4
作者：
Kuniholm MH;Lesi OA;Mendy M;Akano AO;Sam O;Hall AJ;Whittle H;Bah E;Goedert JJ;Hainaut P;Kirk GD
通讯作者：
Kirk GD
影响因子：
5.8
作者：
Sanyal, Arun J.;Yoon, Seung Kew;Lencioni, Riccardo
通讯作者：
Lencioni, Riccardo
DOI：
10.2147/hmer.s16316
发表时间：
2012-05-08
期刊：
Hepatic medicine : evidence and research
影响因子：
--
作者：
Dhanasekaran R;Limaye A;Cabrera R
通讯作者：
Cabrera R
影响因子：
3.6
作者：
Ming-Tzai Chen;Yuan-Hsin Hsu;Tzu-Sui Wang;Shi-Wern Chien
通讯作者：
Shi-Wern Chien
影响因子：
56.9
作者：
SUGIMURA, T
通讯作者：
SUGIMURA, T