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Obesity and Diabetes Are Linked to Increased Risk of Liver Cancer

By Liz Highleyman

Several factors contribute to liver disease progression in people with chronic hepatitis C virus (HCV) infection, and metabolic abnormalities are increasingly recognized as cofactors.

In a study reported in the July 2008 issue of Gastroenterology, researchers investigated whether obesity, diabetes, and other metabolic factors are independently associated with hepatocellular carcinoma (HCC), stratified by hepatitis B virus (HBV) and hepatitis C virus (HCV) serostatus. They also explored the possible joint influence of obesity/diabetes and viral hepatitis on the risk of HCC.

What is Hepatocellular Carcinoma? Most primary liver cancers are classified as hepatocellular carcinoma. Hepatocellular carcinoma is a malignant tumor composed of cells resembling hepatocytes ; however, the resemblance varies with the degree of differentiation . Hepatocellular carcinoma is commonly associated with cirrhosis

The study included 23,820 residents of Taiwan who were followed for 14 years. All analyses were stratified by hepatitis B surface antigen (HBsAg) and anti-HCV antibody status at enrollment; 218 participants who were positive for both HBV and HCV were excluded. Incident HCC cases were identified via linkage to the national cancer registry.

Results

• After controlling for other metabolic factors, extreme obesity (body mass index of 30 kg/m2 or higher) was independently associated with a 4-fold risk of HCC (RR 4.13) among HCV positive participants and a 2-fold risk (RR 2.36) among people with neither HBV nor HCV.

• This association was not seen, however, in HBsAg seropositive participants (RR 1.36).

• Diabetes was associated with HCC in all 3 groups, with the highest risk in those with HCV (RR 3.52) and the lowest in HBV carriers (RR 2.27).

• HBV or HCV positive individuals who were both obese and diabetic had more than a 100-fold increased risk of HCC, indicating synergistic effects of metabolic factors and viral hepatitis.

In conclusion, the study authors wrote, "The finding that both obesity and diabetes are predictors of HCC risk, possibly differently depending on HBV and HCV infection status, may shed some light in preventing HCC."


College of Public Health, National Taiwan University, Taipei; Hepatitis Research Center, National Taiwan University Hospital, Taipei; Genomics Research Center, Academia Sinica, Taipei; Department of Public Health, Tzu-Chi University, Hualien; School of Public Health, National Defense Medical Center, Taipei; Kaohsiung Chang-Gung Memorial Hospital, Kaohsiung, Taiwan.

7/18/08

Reference
CL Chen, HI Yang, WS Yang, and others. Metabolic factors and risk of hepatocellular carcinoma by chronic hepatitis B/C infection: A follow-up study in Taiwan. Gastroenterology 135(1): 111-121. July 2008. ( Abstract )

 





 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


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