Obesity is an independent risk factor for hepatocellular carcinoma development in chronic hepatitis C patients
Obesity is an independent risk factor for hepatocellular carcinoma development in chronic hepatitis C patients
复制标题
DOI：
10.1016/j.cgh.2008.02.012
复制
发表时间：
2008-04-01
影响因子：
12.6
通讯作者：
Omata, Masao
中科院分区：
文献类型：
--
作者：
Ohki, Takamasa;Tateishi, Ryosuke;Omata, Masao
背景与目的：肥胖是否会增强慢性丙型肝炎患者的肝癌发生，目前还没有完全阐明。本研究旨在探讨慢性丙型肝炎患者体重与肝癌发生风险的关系。研究方法：我们招募了1431例慢性丙型肝炎患者，他们在1994年至2004年期间访问了我们的肝脏诊所，不包括那些在他们的访问中患有肝细胞癌（HCC）或既往HCC病史的患者。按体重指数（BMI）分为4组：体重不足组（30 kg/m2，N = 31）;我们通过多变量考克斯比例风险回归分析来评估肥胖对肝癌发生的影响，单变量分析中发现其他危险因素具有显著性。结果如下：在随访期间（平均6.1年），340例患者发生HCC，3年、5年和10年的累积发病率分别为10.5%、19.7%和36.8%。BMI组之间的发病率差异显著（P= 0.007）。调整其他重要因素后，超重和肥胖被证明是HCC的独立危险因素，与体重不足患者相比，其风险比为1.86（95%置信区间，1.09-3.16; P =.022）和3.10（95%置信区间，1.41-6.81; P =.005）。结论：慢性丙型肝炎患者发生HCC的风险与BMI成比例增加，从体重不足到肥胖。
Background & Aims: it is not fully elucidated whether obesity enhances hepatocarcinogenesis in patients with chronic hepatitis C. The aim of this study was to investigate the relationship between body weight and risk of hepatocarcinogenesis in chronic hepatitis C patients. Methods: We enrolled 1431 patients with chronic hepatitis C who visited our liver clinic between 1994 and 2004, excluding those with hepatocellular carcinoma (HCC) at their visit or with a previous history of HCC. They were divided into 4 groups according to body mass index (BMI): underweight ( 30 kg/m(2), N = 3 1). We assessed the impact of obesity on the hepatocarcinogenesis adjusted by multivariate Cox proportional hazard regression with other risk factors found significant in univariate analysis. Results: During the follow-up period (mean, 6.1 y), HCC developed in 340 patients, showing cumulative incidence rates of 10.5%, 19.7%, and 36.8% at 3, 5, and 10 years, respectively. The incidence differed significantly among the BMI groups (P=.007). Adjusting for other significant factors, overweight and obesity were shown to be an independent risk factor of HCC, with a hazard ratio of 1.86 (95% confidence interval, 1.09-3.16; P =.022) and 3.10 (95% confidence interval, 1.41-6.81; P =.005) as compared with the underweight patients. Conclusions: The risk of HCC in patients with chronic hepatitis C increases in proportion to BMI in a wide range of its values, from underweight to obese.