Obesity is an independent risk factor for hepatocellular carcinoma development in chronic hepatitis C patients.
OBJECTIVE
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 (< or =18.5 kg/m(2), N = 112); normal (18.5 to less than 25 kg/m(2), N = 1023); overweight (25 to less than 30 kg/m(2), N = 265); and obese (>30 kg/m(2), N = 31). 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.
Ohki
Takamasa
T
Department of Gastroenterology, University of Tokyo, Hongo, Tokyo, Japan.
Tateishi
Ryosuke
R
Sato
Takahisa
T
Masuzaki
Ryota
R
Imamura
Jun
J
Goto
Tadashi
T
Yamashiki
Noriyo
N
Yoshida
Hideo
H
Kanai
Fumihiko
F
Kato
Naoya
N
Shiina
Shuichiro
S
Yoshida
Haruhiko
H
Kawabe
Takao
T
Omata
Masao
M
D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects; D015992:Body Mass Index; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D019698:Hepatitis C, Chronic / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008113:Liver Neoplasms / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications / Q000453:epidemiology*; D016016:Proportional Hazards Models; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis; D012737:Sex Factors; D000509:alpha-Fetoproteins
D012709:Serum Albumin; D000509:alpha-Fetoproteins