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


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.