KMID : 1040620160220030339
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Clinical and Molecular Hepatology 2016 Volume.22 No. 3 p.339 ~ p.349
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Obesity and hepatocellular carcinoma in patients receiving entecavir for chronic hepatitis B
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Lee Jae-Min
Yoo Sun-Hong Sohn Won Kim Hyung-Woo Choi Yong-Sun Won Jung-Ho Heo Jin-Young Park Sang-Jong Park Young-Min
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Abstract
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Background/Aims: 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 ¡Ã25 kg/m2 (HR=0.90, P=0.894), WC ¡Ã90 cm (HR=1.10, P=0.912), WHR ¡Ã0.9 (HR=1.94, P=0.386), VFA ¡Ã100 cm2 (HR=1.69, P=0.495), and hepatic steatosis (HR=0.57, P=0.602).
Conclusion: HCC development is associated with liver cirrhosis but not obesity-related factors in CHB patients receiving entecavir.
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KEYWORD
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Chronic hepatitis B, Hepatocellular carcinoma, Obesity, Antiviral treatment
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