title: Metabolic risk factors and primary liver cancer in a prospective study of 578,700 adults.
abstract: Initial studies have indicated diabetes and obesity to be risk factors for hepatocellular carcinoma; but the association between other metabolic risk factors and primary liver cancer (PLC) has not been investigated. The metabolic syndrome and cancer project (Me-Can) includes cohorts from Norway, Austria and Sweden with data on 578,700 subjects. We used Cox proportional hazard models to calculate relative risks (RRs) of PLC by body mass index (BMI), blood pressure and plasma levels of glucose, cholesterol and triglycerides as continuous standardized variables (z-score with mean = 0 and standard deviation (SD) = 1) and their standardized sum of metabolic syndrome (MetS) z-score. RRs were corrected for random error in measurements. During an average follow-up of 12.0 years (SD = 7.8), 266 PLCs were diagnosed among cohort members. RR of liver cancer per unit increment of z-score adjusted for age, smoking status and BMI and stratified by birth year, sex and sub-cohorts, was for BMI 1.39 (95% confidence interval (CI) 1.24-1.58), mid blood pressure 2.08 (0.95-4.73), blood glucose 2.13 (1.55-2.94) cholesterol 0.62 (0.51-0.76) and serum triglycerides 0.85 (0.65-1.10). The RR per one unit increment of the MetS z-score was 1.35 (1.12-1.61). BMI, glucose and a composite MetS score were positively and cholesterol negatively associated with risk of liver cancer.
authors.affiliation: Department of Medical Statistics, Informatics and Health Economics, Innsbruck Medical University, Austria.
authors.forename: Wegene
authors.initials: W
authors.lastname: Borena
authors.forename: Susanne
authors.initials: S
authors.lastname: Strohmaier
authors.forename: Annekatrin
authors.initials: A
authors.lastname: Lukanova
authors.forename: Tone
authors.initials: T
authors.lastname: Bjørge
authors.forename: Björn
authors.initials: B
authors.lastname: Lindkvist
authors.forename: Goran
authors.initials: G
authors.lastname: Hallmans
authors.forename: Michael
authors.initials: M
authors.lastname: Edlinger
authors.forename: Tanja
authors.initials: T
authors.lastname: Stocks
authors.forename: Gabriele
authors.initials: G
authors.lastname: Nagel
authors.forename: Jonas
authors.initials: J
authors.lastname: Manjer
authors.forename: Anders
authors.initials: A
authors.lastname: Engeland
authors.forename: Randi
authors.initials: R
authors.lastname: Selmer
authors.forename: Christel
authors.initials: C
authors.lastname: Häggström
authors.forename: Steinar
authors.initials: S
authors.lastname: Tretli
authors.forename: Hans
authors.initials: H
authors.lastname: Concin
authors.forename: Håkan
authors.initials: H
authors.lastname: Jonsson
authors.forename: Pär
authors.initials: P
authors.lastname: Stattin
authors.forename: Hanno
authors.initials: H
authors.lastname: Ulmer
mesh_terms: D000328:Adult; D000368:Aged; D001317:Austria / Q000453:epidemiology; D001786:Blood Glucose; D001794:Blood Pressure; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008055:Lipids / Q000097:blood*; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000378:metabolism*; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications*; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D014280:Triglycerides / Q000097:blood
chemical_list: D001786:Blood Glucose; D008055:Lipids; D014280:Triglycerides; D002784:Cholesterol