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Obesity – factor of hepatocarcinogenesis in chronic hepatitis C
AIM: To investigate whether obesity is a risk factor of hepatocarcinogenesis in chronic hepatitis C patients.
We retrospectively analyzed the incidence of hepatocellular carcinoma (HCC) among patients with HCV infection followed up at 5 hospitals. Between 2002 and 2022, a total of 1365 patients who were positive for HCV, negative for HBsAg, and without HCC visited the 5 hospitals and were followed up. They were divided into four groups according to BMI; BMI < 18.5,n=107; 18.5 < = BMI < 25, n=980; 25 < =BMI < 30, n=251;30 < BMI, n=27) and the cumulative incidence rates of HCC were compared, considering age, sex, alcohol intake, and liver function in multivariate analysis.
There were 698 male and 667 female patients with the median age of 60 year (range 15-85). The follow-up period was 16.1+ 3.1 years, amounting to a total observation period of 8326 person-years. HCC developed in 371 patients, showing cumulative incidence rates of 10.8 %, 20.3%, and 38.9% at 3, 5 and 10 years, respectively. The incidence rates differed significantly among the BDI groups (p=0.007 by the long rank test). Univariate analyses showed that older age, male, comorbidity with diabetes mellitus, heavy alcohol intake, low albumin concentration, high AST level, low platelet count, and high AFP concentration were significant risk factors of HCC. Adjusting for these factors, multivariate Cox proportional hazard regression showed that obesity was an independent risk factor of HCC, with a hazard ratio of 1.795 (95% CI:1.074-3.000; p=0.0260) when25<=BMI <30 and 3.210(95%CI:1.469-7.016, p=0.0035) when 30.
Obesity is an independent risk factor of hepatocarcinogenesis among chronic hepatitis C patients.
The authors.
Has not received any funding.
S. Bogdan: Disclosures not submitted. The other author has declared no conflicts of interest.
