Association of central obesity with hepatocellular carcinoma in patients with chronic hepatitis B receiving antiviral therapy

作者：Fan, Rong; Niu, Junqi; Ma, Hong; Xie, Qing; Cheng, Jun; Rao, Huiying; Dou, Xiaoguang; Xie, Jianping; Zhao, Wei; Peng, Jie; Gao, Zhiliang; Gao, Hongbo; Chen, Xinyue; Chen, Jinjun; Li, Qiang; Tang, Hong; Zhang, Zhengang; Ren, Hong; Cheng, Mingliang; Liang, Xieer; Zhu, Chaonan; Wei, Lai; Jia, Jidong^*; Sun, Jian^*; Hou, Jinlin^*

来源：Alimentary Pharmacology and Therapeutics, 2021, 54(3): 329-338.

DOI：10.1111/apt.16469

• BODY-MASS INDEX
• WAIST CIRCUMFERENCE
• SCREENING TOOL
• RISK
• CANCER
• DISEASE
• RATIO
• MEN

Background Obesity is typically associated with metabolic dysfunction, but its impact on hepatocellular carcinoma (HCC) remains unclear in patients with chronic hepatitis B (CHB). Aim To study the effect of obesity on HCC development in patients with CHB receiving antiviral therapy. Methods We included patients from a Chinese multicentre, prospective, observational, treated CHB cohort in this study. General obesity was evaluated by body-mass index (BMI). Central obesity was evaluated by waist circumference, waist-to-hip ratio and waist-to-height ratio. Results A total of 5754 nucleos(t)ide analogue treated patients were enrolled in the analysis. The 5-year cumulative incidence of HCC was 2.9%. Waist-to-height ratio performed better in predicting HCC development than BMI, waist circumference or waist-to-hip ratio. Patients with central obesity (defined as waist-to-height ratio >0.5) had significantly higher 5-year incidence of HCC than those without central obesity in the overall population (3.9% vs 2.1%, hazard ratio [HR]: 2.06, P = 0.0001) and 745 propensity score matched pairs (4.7% vs 2.3%, HR: 2.04, P = 0.026), respectively. Besides cirrhosis status and aMAP HCC risk score, central obesity was also independently associated with HCC risk (HR: 1.63, P = 0.013). Waist-to-height ratio gain within 1 year was associated with a significantly higher HCC risk with an adjusted HR value of 1.88 (95% confidence interval: 1.12-3.13, P = 0.017). Conclusions Central obesity, evaluated by the waist-to-height ratio, was associated with a twofold increase in HCC risk among CHB patients receiving antiviral treatment, highlighting the important role of abnormal metabolic function in the progression of liver disease.

• 单位
  上海交通大学; 中山大学; 北京大学; 南方医科大学; 中国医科大学; 1; 吉林大学; 华中科技大学; 清华大学