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J Clin Oncol. 2008 Dec 1;26(34):5576-82. doi: 10.1200/JCO.2008.16.1075. Epub 2008 Oct 27.

Body-mass index and progression of hepatitis B: a population-based cohort study in men.

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  • 1Graduate Institute of Epidemiology, College of Public Health, National Taiwan University, Room 522, No.17, Xuzhou Rd, Zhongzheng District, Taipei City 10055, Taiwan. yumw@ntu.edu.tw

Abstract

PURPOSE:

To determine prospectively whether body-mass index (BMI) is associated with liver-related morbidity and mortality among male hepatitis B virus (HBV) carriers.

PATIENTS AND METHODS:

We performed a prospective study of 2,903 male HBV surface antigen-positive government employees who were free of cancer at enrollment between 1989 and 1992. Main outcome measures included ultrasonography, biochemical tests, incident hepatocellular carcinoma (HCC), and liver-related death.

RESULTS:

During mean follow-up of 14.7 years, 134 developed HCC and 92 died as a result of liver-related causes. In Cox proportional hazards models adjusting for age, number of visits, diabetes, and use of alcohol and tobacco, the hazard ratios for incident HCC were 1.48 (95% CI, 1.04 to 2.12) in overweight men (BMI between 25.0 and 29.9 kg/m(2)) and 1.96 (95% CI, 0.72 to 5.38) in obese men (BMI >or= 30.0 kg/m(2)), compared with normal-weight men (BMI between 18.5 and 24.9 kg/m(2)). Liver-related mortality had adjusted hazard ratios of 1.74 (95% CI, 1.15 to 2.65) in overweight men and 1.50 (95% CI, 0.36 to 6.19) in obese men. Excess BMI was also associated with the occurrence of fatty liver and cirrhosis detected by ultrasonography, as well as elevated ALT and gamma-glutamyltransferase (GGT) activity during follow-up. The association of BMI with GGT was stronger than with ALT, and elevated GGT activity and cirrhosis were the strongest predictors for incident HCC and liver-related death.

CONCLUSION:

This longitudinal cohort study indicates that excess body weight is involved in the transition from healthy HBV carrier state to HCC and liver-related death among men.

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