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Cancer Epidemiol Biomarkers Prev. 2019 Sep 18. pii: cebp.0303.2019. doi: 10.1158/1055-9965.EPI-19-0303. [Epub ahead of print]

The influence of metabolic syndrome on the risk of hepatocellular carcinoma in patients with chronic hepatitis B infection in mainland China.

Author information

1
West China Hospital of Sichuan University tyfscu@163.com.
2
West China Hospital of Sichuan University.
3
West China Medical Center of Sichuan University.
4
West China School of Public Health.

Abstract

BACKGROUND:

The association between metabolic syndrome (MS), both in terms of its components and as a whole, and the risk of hepatocellular carcinoma (HCC) in subjects with hepatitis B virus (HBV) infection remains unclear, especially in mainland China.

METHODS:

We prospectively included 6,564 individuals with HBV infection from an initial cohort of 105,397 civil servants. The multivariate-adjusted hazard ratio (HR) and 95% confidence interval (95%CI) were evaluated using Cox proportional hazards models to explore the potential connection between HCC risk and MS. Cumulative incidences were plotted using Kaplan-Meier curves.

RESULTS:

After a 45,668.0 person-year follow-up (76.0±30.8 months) of 6,564 subjects who were seropositive for hepatitis B surface antigen (HBsAg), 89 incident HCC cases were identified. MS as a whole was independently associated with a 2-fold increased HCC risk (HR, 2.25, 95%CI: 1.41-3.60) after adjusting for age (in 1-year increment), gender, cigarette smoking, alcohol consumption, liver cirrhosis and elevated aspartate aminotransferase levels. Subjects with 3 or more factors and those with one or two factors had adjusted increased HCC risks of 2.12-fold (95%CI: 1.16-3.89) and 1.28-fold (95%CI:0.74-2.22), respectively, in comparison to those without any metabolic factors. Central obesity and type 2 diabetes were associated with significantly increased HCC risk, whereas this association was not observed in obese subjects (95%CI: 0.73-3.44).

CONCLUSION:

MS as a whole, central obesity and type 2 diabetes were independently associated with increased HCC risk in a population with HBV infection in mainland China.

IMPACT:

MS may be a risk factor for HCC.

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