Zhuo-Ying Li1, Yu-Ting Tan2, Jing Wang2, Jie Fang2, Da-Ke Liu2, Hong-Lan Li2, Yong-Bing Xiang3. 1. School of Public Health, Fudan University, Shanghai 200032, China; State Key Laboratory of Oncogene and Related Genes & Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200032, China. 2. State Key Laboratory of Oncogene and Related Genes & Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200032, China. 3. School of Public Health, Fudan University, Shanghai 200032, China; State Key Laboratory of Oncogene and Related Genes & Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200032, China. Electronic address: ybxiang@shsci.org.
Abstract
BACKGROUND: Based on a prospective cohort study in middle-aged Chinese men, the current study characterized the dose-response relationships between fat distribution measurements and the incidence of primary liver cancer. METHODS: Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated by Cox regression models for the association between waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), a body shape index (ABSI), and body roundness index (BRI) with liver cancer incidence. Dose-response curves were characterized using a restricted cubic spline function. RESULTS: After a mean follow-up time of 11.9 (SD = 2.4) years, 440 liver cancer cases were identified from 60,625 participants. WC, WHtR, ABSI, and BRI were found to be associated with an increased risk of liver cancer at a given level of body mass index (BMI), with multivariable-adjusted HRs of 1.19 (95% CI: 1.01-1.41), 1.26 (95% CI: 1.02-1.50), 1.12 (95% CI: 1.05-1.23) and 1.28 (95% CI: 1.08-1.53) for per SD increment, respectively. Dose-response curves suggested that the risk increased rapidly above the median levels of WC, WHtR, and BRI. For ABSI, the risk decreased from the minimum level to about the 35th percentile and increased slowly thereafter. CONCLUSIONS: The current study suggested an association between abdominal obesity in middle age and increased risk of primary liver cancer at a given level of BMI. WHtR and BRI were better predictors of liver cancer risk compared with WC and ABSI.
BACKGROUND: Based on a prospective cohort study in middle-aged Chinese men, the current study characterized the dose-response relationships between fat distribution measurements and the incidence of primary liver cancer. METHODS: Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated by Cox regression models for the association between waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), a body shape index (ABSI), and body roundness index (BRI) with liver cancer incidence. Dose-response curves were characterized using a restricted cubic spline function. RESULTS: After a mean follow-up time of 11.9 (SD = 2.4) years, 440 liver cancer cases were identified from 60,625 participants. WC, WHtR, ABSI, and BRI were found to be associated with an increased risk of liver cancer at a given level of body mass index (BMI), with multivariable-adjusted HRs of 1.19 (95% CI: 1.01-1.41), 1.26 (95% CI: 1.02-1.50), 1.12 (95% CI: 1.05-1.23) and 1.28 (95% CI: 1.08-1.53) for per SD increment, respectively. Dose-response curves suggested that the risk increased rapidly above the median levels of WC, WHtR, and BRI. For ABSI, the risk decreased from the minimum level to about the 35th percentile and increased slowly thereafter. CONCLUSIONS: The current study suggested an association between abdominal obesity in middle age and increased risk of primary liver cancer at a given level of BMI. WHtR and BRI were better predictors of liver cancer risk compared with WC and ABSI.