title: Body mass index is associated with age-at-onset of HCV-infected hepatocellular carcinoma patients.
abstract: OBJECTIVE
  To identify factors associated with the age at onset of hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC).
  
  
  METHODS
  Five hundred and fifty-six consecutive patients positive for HCV antibody and treatment-naïve HCC diagnosed between 1995 and 2004 were analyzed. Patients were classified into three groups according to age at HCC onset: < 60 years (n = 79), 60-79 years (n = 439), or ≥ 80 years (n = 38). Differences among groups in terms of sex, body mass index (BMI), lifestyle characteristics, and liver function were assessed. Factors associated with HCC onset in patients < 60 or ≥ 80 years were analyzed by logistic regression analysis.
  
  
  RESULTS
  Significant differences emerged for sex, BMI, degree of smoking and alcohol consumption, mean bilirubin, alanine aminotransferase (ALT), and γ-glutamyl transpeptidase (GGT) levels, prothrombin activity, and platelet counts. The mean BMI values of male patients > 60 years old were lower and mean BMI values of female patients < 60 years old were higher than those of the general Japanese population. BMI > 25 kg/m² [hazard ratio (HR), 1.8, P = 0.045], excessive alcohol consumption (HR, 2.5, P = 0.024), male sex (HR, 3.6, P = 0.002), and GGT levels > 50 IU/L (HR, 2.4, P = 0.014) were independently associated with HCC onset in patients < 60 years. Low ALT level was the only factor associated with HCC onset in patients aged ≥ 80 years.
  
  
  CONCLUSIONS
  Increased BMI is associated with increased risk for early HCC development in HCV-infected patients. Achieving recommended BMI and reducing alcohol intake could help prevent hepatic carcinogenesis.
authors.affiliation: Department of Internal Medicine, Saga Medical School, Saga 8498501, Japan.
authors.forename: Takumi
authors.initials: T
authors.lastname: Akiyama
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Mizuta
authors.forename: Seiji
authors.initials: S
authors.lastname: Kawazoe
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Eguchi
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Kawaguchi
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Takahashi
authors.forename: Iwata
authors.initials: I
authors.lastname: Ozaki
authors.forename: Kazuma
authors.initials: K
authors.lastname: Fujimoto
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects; D015992:Body Mass Index; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000821:virology*; D005260:Female; D006526:Hepatitis C / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D008019:Life Style; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000821:virology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors