|Title:||Obesity and Alcohol Synergize to Increase the Risk of Incident Hepatocellular Carcinoma in Men||Authors:||Loomba, Rohit
|Keywords:||Hepatocellular Carcinoma;Epidemiology;Cirrhosis;Nutrition||Issue Date:||2010||Start page/Pages:||891-898.e2||Source:||Clinical Gastroenterology and Hepatology||Abstract:||
Body mass index (BMI) and alcohol use are risk factors for hepatocellular carcinoma (HCC). We performed a prospective study to determine if these factors have synergistic effects on HCC risk. METHODS: Over 14 years, we followed up 2260 Taiwanese men from the Risk Evaluation of Viral Load Elevation and Associated Liver Disease/Cancer-Hepatitis B Virus (REVEAL- HBV) Study Cohort who tested positive for the hepatitis B surface antigen (mean age, 46 +/- 10 y; mean BMI , 24 +/- 3 kg/m(2)); 20% reported alcohol use. Incident HCC cases were identified via linkage to the national cancer registry. Multivariate-adjusted hazard ratio (HR) and 95% confidence interval (Cl) were estimated using Cox- proportional hazards models. RESULTS: In univariate analysis , the interaction between BMI and alcohol predicted incident HCC (p = .029). Alcohol use and extreme obesity (BMI >= 30 kg/m(2)) had synergistic effects on the risk of incident HCC in analyses adjusted for age (HR, 3.41; 95% CI, 1.25-9.27; P < .025) and multivariables (HR, 3.40; 95% CI, 1.24-9.34; P < .025). The relative risk estimate for the interaction and the attributable proportion from the interaction and synergy index were 1.59, 0.52, and 4.40, respectively; these indicate a multiplicative interaction between alcohol use and extreme obesity. In an analysis stratified into 4 World Health Organization categories of BMI and alcohol use, the risk of incident HCC increased in overweight (HR, 2.4; 95% CI, 1.3-4.4), obese (HR, 2.0; 95% CI , 1.1-3.7), and extremely obese (HR, 2.9; 95% CI, 1.0-8.0) users of alcohol( P for trend = .046). CONCLUSIONS: Obesity and alcohol have synergistic effects to increase the risk of incident HCC in hepatitis B surface antigen-positive men. Lifestyle interventions might reduce the incidence of HCC.
|Appears in Collections:||流行病學與預防醫學研究所|
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