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

Research paper by Yifei Y Tan, Xiaoyun X Zhang, Wei W Zhang, Li L Tang, Hanwei H Yang, Ke K Yan, Li L Jiang, Jian J Yang, Chuan C Li, Jiayin J Yang, Tianfu T Wen, Huairong H Tang, Lunan L Yan

Indexed on: 21 Sep '19Published on: 20 Sep '19Published in: Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology



Abstract

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. 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. 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). 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. MS may be a risk factor for HCC. Copyright ©2019, American Association for Cancer Research.