Young Chang1, Jeong-Ju Yoo2, Dong Wook Shin3,4, Su Jong Yu5, Eun Ju Cho6, Kyungdo Han7, Dahye Kim7, Bo-Yeon Kim8, Goh Eun Chung9, Yuri Cho10. 1. Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Republic of Korea. 2. Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea. 3. Department of Family Medicine/Supportive Care Center, Samsung Medical Center Supportive Care Center, Samsung Comprehensive Cancer Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea. dwshin.md@gmail.com. 4. Center for Clinical Epidemiology, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea. dwshin.md@gmail.com. 5. Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. ydoctor2@hanmail.net. 6. Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. 7. Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea. 8. Division of Endocrinology, Department of Internal Medicine, Soonchunhyang University School of Medicine Bucheon Hospital, Bucheon, Republic of Korea. 9. Department of Internal Medicine and Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea. 10. Department of Internal Medicine, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Republic of Korea.
Abstract
BACKGROUND/AIM: The importance of hepatocellular carcinoma (HCC) caused by obesity has been emphasized. Many studies have shown that weight fluctuations as well as high BMI are associated with various adverse outcomes. In this study, we investigated the relationship between weight fluctuation and HCC in general populations drawn from a nationwide population-based cohort. METHOD: A population-based cohort study including 8,001,829 subjects participating in more than three health examinations within 5 years from the index year were followed until the end of 2017. The degree of weight fluctuation and incidence of HCC during the period were evaluated. RESULTS: When we classified groups according to baseline body mass index (BMI) level, the highest risk for HCC was observed in subjects with BMI of 30 or greater (adjusted hazard ratio [aHR] 1.40, 95% confidence interval [CI] 1.27-1.54). Also, increasing trends for the relationship between weight fluctuation and HCC were observed in multivariable Cox proportional analyses. The risk of HCC increased by 16% (aHR 1.16, 95% CI 1.12-1.20) for the highest quartile of weight fluctuation relative to the lowest quartile. These findings were consistent regardless of the baseline BMI or other metabolic factors. However, these effects of weight fluctuation on HCC were not observed in liver cirrhosis or viral hepatitis subgroups. CONCLUSION: Weight fluctuation is an independent predictor of HCC. In the absence of liver cirrhosis or chronic hepatitis, the impact of weight fluctuation on HCC is further emphasized. These results suggest maintaining steady weight is recommended to reduce the risk of HCC.
BACKGROUND/AIM: The importance of hepatocellular carcinoma (HCC) caused by obesity has been emphasized. Many studies have shown that weight fluctuations as well as high BMI are associated with various adverse outcomes. In this study, we investigated the relationship between weight fluctuation and HCC in general populations drawn from a nationwide population-based cohort. METHOD: A population-based cohort study including 8,001,829 subjects participating in more than three health examinations within 5 years from the index year were followed until the end of 2017. The degree of weight fluctuation and incidence of HCC during the period were evaluated. RESULTS: When we classified groups according to baseline body mass index (BMI) level, the highest risk for HCC was observed in subjects with BMI of 30 or greater (adjusted hazard ratio [aHR] 1.40, 95% confidence interval [CI] 1.27-1.54). Also, increasing trends for the relationship between weight fluctuation and HCC were observed in multivariable Cox proportional analyses. The risk of HCC increased by 16% (aHR 1.16, 95% CI 1.12-1.20) for the highest quartile of weight fluctuation relative to the lowest quartile. These findings were consistent regardless of the baseline BMI or other metabolic factors. However, these effects of weight fluctuation on HCC were not observed in liver cirrhosis or viral hepatitis subgroups. CONCLUSION: Weight fluctuation is an independent predictor of HCC. In the absence of liver cirrhosis or chronic hepatitis, the impact of weight fluctuation on HCC is further emphasized. These results suggest maintaining steady weight is recommended to reduce the risk of HCC.
Entities:
Keywords:
Body mass index; Diabetes; Fatty liver; Fluctuation; Hepatocellular carcinoma; Inflammation; Metabolic dysfunction; Obesity; Telomere; Weight
Authors: Ji Eun Lee; Kyungdo Han; Juhwan Yoo; Yohwan Yeo; In Young Cho; Belong Cho; Hyuktae Kwon; Dong Wook Shin; Jong Ho Cho; Yong-Moon Park Journal: J Pers Med Date: 2022-03-01