title: Risk factors of cryptogenic hepatocellular carcinoma in patients with low body mass index or without metabolic syndrome.
abstract: OBJECTIVE
  Many patients are diagnosed with cryptogenic hepatocellular carcinoma (HCC) without metabolic syndrome (MS). We investigated the risk factors for cryptogenic HCC in patients with a low body mass index (BMI) or without MS.
  
  
  METHODS
  Thirty-six patients were diagnosed with cryptogenic HCC over a 10-year period at a tertiary research hospital. Data including BMI score and risk factors for MS were analyzed retrospectively. Patients with fewer than two risk factors for MS (n = 16) were compared with those with two or more risk factors (n = 20). Patients with high BMI (≥ 23 kg/m(2), n = 20) were also compared with those with lower BMI (n = 16).
  
  
  RESULTS
  Patients with fewer than two risk factors for MS were significantly more likely to smoke and be hepatitis B surface antibodies (anti-HBs)-positive vs. patients with two or more risk factors. However, only smoking was statistically significant on multivariate analysis. Peaks of BMI were observed in two regions. Lower BMI was significantly associated with the presence of anti-HBs compared with high BMI, although this association was not statistically significant on multivariate analysis.
  
  
  CONCLUSIONS
  Smoking is a potential risk factor for cryptogenic HCC in patients without MS. Remote hepatitis B virus infection may be a risk factor for cryptogenic HCC in patients without MS or with a low BMI.
authors.affiliation: Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
authors.forename: Hwa Young
authors.initials: HY
authors.lastname: Song
authors.forename: Hyo Keun
authors.initials: HK
authors.lastname: Lee
authors.forename: June Sung
authors.initials: JS
authors.lastname: Lee
authors.forename: Jong Yeon
authors.initials: JY
authors.lastname: Kim
authors.forename: Yun Hyuk
authors.initials: YH
authors.lastname: Yim
authors.forename: Tae Jun
authors.initials: TJ
authors.lastname: Song
authors.forename: Won Ki
authors.initials: WK
authors.lastname: Bae
authors.forename: Nam-Hoon
authors.initials: NH
authors.lastname: Kim
authors.forename: Kyung-Ah
authors.initials: KA
authors.lastname: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology*; D016009:Chi-Square Distribution; D005260:Female; D006509:Hepatitis B / Q000175:diagnosis / Q000453:epidemiology; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000276:immunology; D006801:Humans; D008113:Liver Neoplasms / Q000453:epidemiology*; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D013997:Time Factors
chemical_list: D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens