title: Glycemic load in relation to hepatocellular carcinoma among patients with chronic hepatitis infection.
abstract: BACKGROUND
  Chronic infections with hepatitis B virus (HBV) and hepatitis C virus (HCV) are of paramount etiologic importance for hepatocellular carcinoma (HCC), but other factors are likely to be important. The association of diabetes mellitus and obesity with HCC raises the possibility that dietary glycemic load (GL) may interact with chronic hepatitis infection in the causation of HCC.
  
  
  METHODS
  We conducted a case-control study of 333 HCC patients and 360 controls in Athens, Greece. Third-generation assays were used to determine chronic HBV and HCV infection and information from a semiquantitative food frequency questionnaire to estimate dietary GL.
  
  
  RESULTS
  After adjustment for possible confounding factors through multiple logistic regression, we found a nonsignificant positive association between GL and HCC, which was exclusively accounted for by a positive association between GL and HCC cases with chronic infection with hepatitis B and/or C. For the latter group of patients, the odds ratio at the highest compared with the lowest GL quintile was 1.95 (95% confidence interval 1.09-3.48). The association was strengthened after exclusion of subjects with diabetes.
  
  
  CONCLUSIONS
  Our results indicate that, among patients with chronic infection with HBV and/or HCV, reduction of dietary GL could reduce risk or delay development of HCC.
authors.affiliation: Department of Hygiene, Epidemiology and Biostatistics, University of Athens Medical School, Athens, Greece.
authors.forename: P
authors.initials: P
authors.lastname: Lagiou
authors.forename: M
authors.initials: M
authors.lastname: Rossi
authors.forename: A
authors.initials: A
authors.lastname: Tzonou
authors.forename: C
authors.initials: C
authors.lastname: Georgila
authors.forename: D
authors.initials: D
authors.lastname: Trichopoulos
authors.forename: C
authors.initials: C
authors.lastname: La Vecchia
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000209:etiology* / Q000821:virology*; D016022:Case-Control Studies; D004032:Diet; D005260:Female; D038321:Glycemic Index / Q000502:physiology*; D006115:Greece / Q000453:epidemiology; D016174:Hepacivirus / Q000235:genetics; D006509:Hepatitis B / Q000150:complications; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics; D006526:Hepatitis C / Q000150:complications; D006521:Hepatitis, Chronic / Q000150:complications*; D006801:Humans; D007407:Interviews as Topic; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000473:pathology; D008113:Liver Neoplasms / Q000209:etiology* / Q000821:virology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D006514:Hepatitis B Surface Antigens