The Influence of Metabolic Syndrome on the Risk of Hepatocellular Carcinoma in Patients with Chronic Hepatitis B Infection in Mainland China

作者：Yifei Tan, Xiaoyun Zhang, Wei Zhang, Li Tang, Hanwei Yang, Ke Yan, Li Jiang, Jian Yang, Chuan Li, Jiayin Yang, Tianfu Wen, Huairong Tang, Lünan Yan · 发表于：Cancer Epidemiology Biomarkers & Prevention · 年份：2019 · DOI：10.1158/1055-9965.epi-19-0303 · 被引用次数：31 · 研究领域：Diabetes, Cardiovascular Risks, and Lipoproteins、Liver Disease Diagnosis and Treatment、Hepatitis B Virus Studies

Abstract Background: The association between metabolic syndrome (MS), both in terms of its components and as a whole, and the risk of hepatocellular carcinoma (HCC) in subjects with hepatitis B virus (HBV) infection remains unclear, especially in mainland China. Methods: We prospectively included 6,564 individuals with HBV infection from an initial cohort of 105,397 civil servants. The multivariate-adjusted HR and 95% confidence interval (95% CI) were evaluated using Cox proportional hazards models to explore the potential connection between HCC risk and MS. Cumulative incidences were plotted using Kaplan–Meier curves. Results: After a 45,668.0 person-year follow-up (76.0 ± 30.8 months) of 6,564 subjects who were seropositive for hepatitis B surface antigen, 89 incident HCC cases were identified. MS as a whole was independently associated with a 2-fold increased HCC risk (HR, 2.25; 95% CI, 1.41–3.60) after adjusting for age (in 1-year increments), gender, cigarette smoking, alcohol consumption, liver cirrhosis, and elevated aspartate aminotransferase levels (≥40 U/L). Subjects with three or more factors and those with one or two factors had adjusted increased HCC risks of 2.12-fold (95% CI, 1.16–3.89) and 1.28-fold (95% CI, 0.74–2.22), respectively, in comparison with those without any metabolic factors. Central obesity and type 2 diabetes were associated with significantly increased HCC risk, whereas this association was not observed in obese subjects (body mass index ≥30 kg...