Isabelle Archambeaud1, Hélène Auble1, Pierre Nahon2, Lucie Planche3, Guillaume Fallot4, Roger Faroux5, Jérôme Gournay1, Didier Samuel4, Sebastien Kury6, Cyrille Féray7. 1. Institut des Maladies de l'Appareil Digestif, Hôtel-Dieu, Nantes, France. 2. Service d'Hépatologie, Hôpital Jean Verdier, Bondy, and INSERM U674, Université Paris 5, France. 3. Cellule de Promotion à la Recherche Clinique, Hôtel-Dieu, Nantes, France. 4. Centre Hépato-Biliaire and INSERM 785, Hôpital Paul Brousse, Villejuif, France. 5. Hôpital de la Roche/Yon, Roche/Yon, France. 6. Laboratoire de Génétique, Hôtel-Dieu, Nantes, France. 7. Service d'hépatologie, Hôpital Henri Mondor, Créteil, France.
Abstract
BACKGROUND & AIMS: In patients with cirrhosis, the risk of hepatocellular carcinoma (HCC) depends upon age, gender and the etiology of liver disease. Few studies are available in Caucasian patients with alcoholic or metabolic cirrhosis without viral hepatitis. METHODS: Cross-sectional clinical data from 905 HCV- and HBV-negative Caucasian patients with alcoholic or metabolic cirrhosis were prospectively collected in four French centres. The risk factors for HCC were identified by logistic regression analysis in the whole population and in a nested case-control study. RESULTS: The etiology of cirrhosis was alcoholic (48%), metabolic (7%) or mixed (45%). Patients were predominantly male (80%), mean age 62 years old and 31% had HCC. Mean body mass index (BMI) was 27 ± 5 and 30% were obese at inclusion. The maximum BMI reached throughout life was 31 ± 6 and 63% had been obese. Ninety percent of the population had daily alcohol consumption, 73% were smokers. Hepatocellular carcinoma was independently related to male gender (P < 0.0001), older age (P < 0.0001), past obesity (P = 0.007), diabetes (P = 0.037), abnormal levels of transaminases (P < 0.0001) and tobacco consumption (P = 0.007). The case-control study (200 HCC cases matched with 400 non-HCC cases for gender, age and Child-Pugh score) confirmed past obesity, tobacco and abnormal levels of transaminases. CONCLUSIONS: Beside diabetes, male gender and age, a past history of obesity, but not an existing overweight, as well as exposure to tobacco and elevated transaminases were three risk factors which could improve the strategy for HCC screening in Caucasian cirrhotic patients without hepatitis B or C.
BACKGROUND & AIMS: In patients with cirrhosis, the risk of hepatocellular carcinoma (HCC) depends upon age, gender and the etiology of liver disease. Few studies are available in Caucasian patients with alcoholic or metabolic cirrhosis without viral hepatitis. METHODS: Cross-sectional clinical data from 905 HCV- and HBV-negative Caucasian patients with alcoholic or metabolic cirrhosis were prospectively collected in four French centres. The risk factors for HCC were identified by logistic regression analysis in the whole population and in a nested case-control study. RESULTS: The etiology of cirrhosis was alcoholic (48%), metabolic (7%) or mixed (45%). Patients were predominantly male (80%), mean age 62 years old and 31% had HCC. Mean body mass index (BMI) was 27 ± 5 and 30% were obese at inclusion. The maximum BMI reached throughout life was 31 ± 6 and 63% had been obese. Ninety percent of the population had daily alcohol consumption, 73% were smokers. Hepatocellular carcinoma was independently related to male gender (P < 0.0001), older age (P < 0.0001), past obesity (P = 0.007), diabetes (P = 0.037), abnormal levels of transaminases (P < 0.0001) and tobacco consumption (P = 0.007). The case-control study (200 HCC cases matched with 400 non-HCC cases for gender, age and Child-Pugh score) confirmed past obesity, tobacco and abnormal levels of transaminases. CONCLUSIONS: Beside diabetes, male gender and age, a past history of obesity, but not an existing overweight, as well as exposure to tobacco and elevated transaminases were three risk factors which could improve the strategy for HCC screening in Caucasian cirrhotic patients without hepatitis B or C.
Authors: Fasiha Kanwal; Saira Khaderi; Amit G Singal; Jorge A Marrero; Nicole Loo; Sumeet K Asrani; Christopher I Amos; Aaron P Thrift; Xiangjun Gu; Michelle Luster; Abeer Al-Sarraj; Jing Ning; Hashem B El-Serag Journal: Hepatology Date: 2022-03-01 Impact factor: 17.298