title: Obesity and hepatocellular carcinoma in patients receiving entecavir for chronic hepatitis B.
abstract: OBJECTIVE
  This study aimed to clarify the effect of obesity on the development of hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) patients receiving antiviral treatment.
  
  
  METHODS
  This study applied a retrospective analysis to a historical cohort in Bundang Jesaeng Hospital. In total, 102 CHB patients were treated with entecavir as an initial treatment for CHB and checked for obesity using a body composition analyzer. Hepatic steatosis was measured semiquantitatively using Hamaguchi's scoring system in ultrasonography. Risk factors for the development of HCC were analyzed, including obesity-related factors (body mass index [BMI], waist circumference [WC], waist-to-hip ratio [WHR], visceral fat area [VFA], and hepatic steatosis).
  
  
  RESULTS
  The median follow-up duration of the patients was 45.2 months (interquartile range: 36.0-58.3 months). The cumulative incidence rates of HCC at 1 year, 3 years, and 5 years were 0%, 5.3%, and 9.0%, respectively. Univariable analysis revealed that the risk factors for HCC development were a platelet count of <120,000 /mm2(hazard ratio [HR]=5.21,P=0.031), HBeAg negativity (HR=5.61,P=0.039), and liver cirrhosis (HR=10.26,P=0.031). Multivariable analysis showed that the significant risk factor for HCC development was liver cirrhosis (HR=9.07,P=0.042). However, none of the obesity-related risk factors were significantly associated with HCC: BMI ≥25 kg/m2(HR=0.90,P=0.894), WC ≥90 cm (HR=1.10,P=0.912), WHR ≥0.9 (HR=1.94,P=0.386), VFA ≥100 cm2(HR=1.69,P=0.495), and hepatic steatosis (HR=0.57,P=0.602).
  
  
  CONCLUSIONS
  HCC development is associated with liver cirrhosis but not obesity-related factors in CHB patients receiving entecavir.
authors.affiliation: Department of Internal Medicine, Bundang Jesaeng Hospital, Seongnam, Korea.
authors.forename: Jaemin
authors.initials: J
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Bundang Jesaeng Hospital, Seongnam, Korea.|Liver Center, Bundang Jesaeng Hospital, Seongnam, Korea.
authors.forename: Sun Hong
authors.initials: SH
authors.lastname: Yoo
authors.affiliation: Department of Internal Medicine, Bundang Jesaeng Hospital, Seongnam, Korea.|Liver Center, Bundang Jesaeng Hospital, Seongnam, Korea.
authors.forename: Won
authors.initials: W
authors.lastname: Sohn
authors.affiliation: Department of Internal Medicine, Bundang Jesaeng Hospital, Seongnam, Korea.
authors.forename: Hyung Woo
authors.initials: HW
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Bundang Jesaeng Hospital, Seongnam, Korea.
authors.forename: Yong Sun
authors.initials: YS
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Bundang Jesaeng Hospital, Seongnam, Korea.
authors.forename: Jung Ho
authors.initials: JH
authors.lastname: Won
authors.affiliation: Department of Internal Medicine, Bundang Jesaeng Hospital, Seongnam, Korea.
authors.forename: Jin Young
authors.initials: JY
authors.lastname: Heo
authors.affiliation: Department of Internal Medicine, Bundang Jesaeng Hospital, Seongnam, Korea.|Liver Center, Bundang Jesaeng Hospital, Seongnam, Korea.
authors.forename: Sang Jong
authors.initials: SJ
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Bundang Jesaeng Hospital, Seongnam, Korea.|Liver Center, Bundang Jesaeng Hospital, Seongnam, Korea.
authors.forename: Young Min
authors.initials: YM
authors.lastname: Park
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D015992:Body Mass Index; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000209:etiology*; D015331:Cohort Studies; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006515:Hepatitis B virus / Q000235:genetics / Q000302:isolation & purification; D019694:Hepatitis B, Chronic / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D015994:Incidence; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; C413685:entecavir; D006147:Guanine
keywords: Antiviral treatment; Chronic hepatitis B; Hepatocellular carcinoma; Obesity