title: Dietary fatty acids and risk of hepatocellular carcinoma in the Singapore Chinese health study.
abstract: Lipidomic signature of lipid metabolism suggests that omega-6 polyunsaturated fatty acids (PUFA) may play a role in oncogenesis of hepatocellular carcinoma (HCC). Hence, we examined the association between dietary fatty acids and risk of HCC.
  
  
  
  We used data from the Singapore Chinese Health Study, a population-based prospective cohort of 63 257 Chinese men and women aged 45-74 years enrolled between 1993 and 1998. Information on current diet assessed via a validated semi-quantitative food frequency questionnaire, medical history and lifestyle factors were obtained through in-person interview, and incidence of HCC recorded through 31 Dec 2010. We also examined the association between dietary fatty acids and HCC risk using a case-control set of 92 cases and 274 controls with available serological biomarkers of chronic infections with hepatitis B virus (HBV) and hepatitis C virus (HCV) nested within this cohort.
  
  
  
  Among the dietary fat components examined, which included saturated, monounsaturated, omega-3 and omega-6 PUFA, only omega-6 PUFA intake displayed a dose-dependent, positive association with HCC risk (p for trend = 0.02). Compared to the lowest quartile, the hazard ratio for the highest quartile intake was 1.49 [(95% confidence interval (CI):1.08-2.07)]. In the nested case-control study, only among individuals negative for serology markers of chronic infection with HBV or HCV, those who consumed above median levels of dietary omega-6 PUFA had increased HCC risk (odds ratio = 4.36, 95% CI = 1.59-11.94) compared to those with lower intake.
  
  
  
  Dietary omega-6 PUFA may be implicated in the risk of non-viral hepatitis related HCC.
authors.affiliation: Duke-NUS Graduate Medical School, National University of Singapore, Singapore City, Singapore.|Saw Swee Hock School of Public Health, National University of Singapore, Singapore City, Singapore.
authors.forename: Woon-Puay
authors.initials: WP
authors.lastname: Koh
authors.affiliation: Division of Gastroenterology, University Medicine Cluster, National University Health System, Singapore City, Singapore.|Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore City, Singapore.
authors.forename: Yock Young
authors.initials: YY
authors.lastname: Dan
authors.affiliation: Duke-NUS Graduate Medical School, National University of Singapore, Singapore City, Singapore.|Department of Gastroenterology & Hepatology, Singapore General Hospital, Singapore City, Singapore.
authors.forename: George Boon-Bee
authors.initials: GB
authors.lastname: Goh
authors.affiliation: National Registry of Diseases Office, Health Promotion Board, Singapore City, Singapore.
authors.forename: Aizhen
authors.initials: A
authors.lastname: Jin
authors.affiliation: Division of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute, Pennsylvania, PA, USA.
authors.forename: Renwei
authors.initials: R
authors.lastname: Wang
authors.affiliation: Division of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute, Pennsylvania, PA, USA.|Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, PA, USA.
authors.forename: Jian-Min
authors.initials: JM
authors.lastname: Yuan
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000453:epidemiology*; D016022:Case-Control Studies; D004032:Diet; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage; D043371:Fatty Acids, Omega-6 / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D015994:Incidence; D008113:Liver Neoplasms / Q000097:blood / Q000453:epidemiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012846:Singapore / Q000453:epidemiology
chemical_list: D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6
keywords: dietary fatty acids; hepatocellular carcinoma; non-alcoholic steatohepatitis; omega-6 fatty acids; polyunsaturated fatty acids