title: Plasma adipokines and risk of hepatocellular carcinoma in chronic hepatitis B virus-infected carriers: a prospective study in taiwan.
abstract: BACKGROUND
  Obesity is considered a risk factor for hepatocellular carcinoma (HCC). The relationship between adipocytokine and HCC in hepatitis B virus (HBV) carriers remains unclear. We prospectively investigated the association of adiponectin, leptin, and visfatin levels with HCC.
  
  
  METHODS
  We conducted a nested case-control study in a community-based cohort with 187 incident HCC and 374 HCC-free HBV carriers. Unconditional logistic regression was conducted to estimate the ORs and 95% confidence intervals (CI).
  
  
  RESULTS
  Adiponectin, but not leptin and visfatin, levels were associated with an increased risk of HCC after adjustment for other metabolic factors and HBV-related factors. The risk was increased [OR = 0.51; 95% CI, 0.12-2.11; OR = 4.88 (1.46-16.3); OR = 3.79 (1.10-13.0); OR = 4.13 (1.13-15.1) with each additional quintiles, respectively] with a significant dose-response trend (P(trend) = 0.003). HCC risk associated with higher adiponectin level was higher in HBV carriers with ultrasonographic fatty liver, genotype C infection, higher viral load, and with elevated alanine aminotransferase. Longitudinally, participants with higher adiponectin were less likely to achieve surface antigen of hepatitis B virus (HBsAg) seroclearance and more likely to have persistently higher HBV DNA. Eventually, they were more likely to develop liver cirrhosis [OR = 1.65 (0.62-4.39); OR = 3.85 (1.47-10.1); OR = 2.56 (0.96-6.84); OR = 3.76 (1.33-10.7) for the second, third, fourth, and fifth quintiles, respectively; P(trend) = 0.017] before HCC.
  
  
  CONCLUSIONS
  Elevated adiponectin levels were independently associated with an increased risk of HCC.
  
  
  CONCLUSIONS
  Adiponectin may play different roles in the virus-induced and metabolic-related liver diseases, but the underlying mechanism remains unknown.
authors.affiliation: Graduate Institute of Clinical Medicine, College of Medicine; Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University; chencj@gate.sinica.edu.tw chlnchen@ntu.edu.tw.
authors.forename: Chi-Ling
authors.initials: CL
authors.lastname: Chen
authors.affiliation: Graduate Institute of Clinical Medicine, College of Medicine; Department of Internal Medicine; Hepatitis Research Center, National Taiwan University Hospital;
authors.forename: Wei-Shiung
authors.initials: WS
authors.lastname: Yang
authors.affiliation: Genomics Research Center, Academia Sinica, Taipei; Graduate Institute of Clinical Medical Science, China Medical University; Molecular and Genomic Epidemiology Center, China Medical University Hospital, Taichung; and.
authors.forename: Hwai-I
authors.initials: HI
authors.lastname: Yang
authors.affiliation: Department of Medicine, Mackay Medical College;
authors.forename: Chuen-Fei
authors.initials: CF
authors.lastname: Chen
authors.affiliation: Genomics Research Center, Academia Sinica, Taipei;
authors.forename: San-Lin
authors.initials: SL
authors.lastname: You
authors.affiliation: Department of Medicine, Mackay Medical College;
authors.forename: Li-Yu
authors.initials: LY
authors.lastname: Wang
authors.affiliation: Department of Gastroenterology, Kaohsiung Chang-Gung Memorial Hospital, Kaohsiung, Taiwan.
authors.forename: Sheng-Nan
authors.initials: SN
authors.lastname: Lu
authors.affiliation: Graduate Institute of Clinical Medicine, College of Medicine; Department of Internal Medicine; Hepatitis Research Center, National Taiwan University Hospital;
authors.forename: Chun-Jen
authors.initials: CJ
authors.lastname: Liu
authors.affiliation: Graduate Institute of Clinical Medicine, College of Medicine; Department of Internal Medicine; Hepatitis Research Center, National Taiwan University Hospital;
authors.forename: Jia-Horng
authors.initials: JH
authors.lastname: Kao
authors.affiliation: Graduate Institute of Clinical Medicine, College of Medicine; Department of Internal Medicine; Hepatitis Research Center, National Taiwan University Hospital;
authors.forename: Pei-Jer
authors.initials: PJ
authors.lastname: Chen
authors.affiliation: Graduate Institute of Clinical Medicine, College of Medicine; Genomics Research Center, Academia Sinica, Taipei; Department of Internal Medicine; Hepatitis Research Center, National Taiwan University Hospital;
authors.forename: Ding-Shinn
authors.initials: DS
authors.lastname: Chen
authors.affiliation: Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University; Genomics Research Center, Academia Sinica, Taipei; chencj@gate.sinica.edu.tw chlnchen@ntu.edu.tw.
authors.forename: Chien-Jen
authors.initials: CJ
authors.lastname: Chen
mesh_terms: D054392:Adipokines / Q000097:blood; D052242:Adiponectin / Q000097:blood*; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000453:epidemiology / Q000821:virology; D016022:Case-Control Studies; D016207:Cytokines / Q000097:blood; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications*; D006801:Humans; D015994:Incidence; D020738:Leptin / Q000097:blood; D008113:Liver Neoplasms / Q000097:blood* / Q000453:epidemiology / Q000821:virology; D008297:Male; D008875:Middle Aged; D054409:Nicotinamide Phosphoribosyltransferase / Q000097:blood; D012307:Risk Factors
chemical_list: D054392:Adipokines; D052242:Adiponectin; D016207:Cytokines; D020738:Leptin; D054409:Nicotinamide Phosphoribosyltransferase; C085455:nicotinamide phosphoribosyltransferase, human