Dietary glycemic load and hepatocellular carcinoma with or without chronic hepatitis infection.
BACKGROUND
Hepatitis B virus (HBV) and hepatitis C virus (HCV) are the major risk factors for hepatocellular carcinoma (HCC). The association of diabetes mellitus with HCC suggests that dietary glycemic load (GL) may influence HCC risk. We have examined the association between dietary GL and HCC.


METHODS
We conducted a hospital-based case-control study in Italy in 1999-2002, including 185 HCC cases and 412 controls who answered a validated food frequency questionnaire and provided blood samples. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were computed using unconditional multiple logistic regression.


RESULTS
We observed a positive association between GL and HCC overall, with an OR of 3.02 (95% CI 1.49-6.12) for the highest quintile of GL compared with the lowest and a significant trend. The OR among HCC cases with evidence of chronic infection with HBV and/or HCV was 3.25 (95% CI 1.46-7.22), while the OR among those with no evidence of infection was 2.45 (95% CI 0.69-8.64), with no significant trend. The association was not explained by the presence of cirrhosis or diabetes.


CONCLUSIONS
High dietary GL is associated with increased risk for HCC. The positive association was most pronounced among HCC cases with HBV and/or HCV markers.
Rossi
M
M
Department of Epidemiology, Mario Negri Institute for Pharmacological Research, Milan, Italy.
Lipworth
L
L
Maso
L Dal
LD
Talamini
R
R
Montella
M
M
Polesel
J
J
McLaughlin
J K
JK
Parpinel
M
M
Franceschi
S
S
Lagiou
P
P
La Vecchia
C
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000209:etiology*; D016022:Case-Control Studies; D003920:Diabetes Mellitus; D004032:Diet; D005260:Female; D038321:Glycemic Index / Q000502:physiology*; D019694:Hepatitis B, Chronic / Q000150:complications; D019698:Hepatitis C, Chronic / Q000150:complications; D006521:Hepatitis, Chronic / Q000150:complications*; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000209:etiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires