한빛사 논문
Yun Bin Lee,1* Hyemi Moon,2* Jeong-Hoon Lee,1* Eun Ju Cho,1 Su Jong Yu,1 Yoon Jun Kim,1 Fabien Zoulim,3 Juneyoung Lee,2 Jung-Hwan Yoon1
1Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
2Department of Biostatistics, College of Medicine, Korea University, Seoul, Korea
3Cancer Research Centre of Lyon, INSERM U1052, Lyon University, Hospices Civils de Lyon, Lyon, France
*These authors contributed equally to this work.
Address all correspondence and requests for reprints to: Yun Bin Lee, MD, PhD, Juneyoung Lee, PhD
Abstract
Background and Aims
Long‐term antiviral therapy can effectively suppress viral replication and improve clinical outcomes in patients with chronic hepatitis B (CHB), but it cannot eliminate risk of hepatocellular carcinoma (HCC). We investigated the association of metabolic risk factors with the risks of cancer and all‐cause mortality in CHB patients.
Approach and Results
This nationwide population‐based study from the Korean National Health Insurance Service database consisted of adults with CHB who underwent health examinations from 2007 through 2012. We collected baseline data on metabolic risk factors, including obesity, high blood pressure, hypercholesterolemia, and diabetes. The risks of developing HCC, non‐HCC cancer, and overall death were analyzed according to the metabolic risk profile. The study population comprised of 317,856 patients (median age, 46 years [interquartile range, 37–54 years]; 219,418 men [69.0%]) had 2,609,523.8 person‐years of follow‐up. A total of 18,850 HCCs, 22,164 non‐HCC cancers, and 15,768 deaths were observed during a median follow‐up period of 8.5 years. The metabolic risk factor burden was positively associated with the risks of HCC, non‐HCC cancer, and all‐cause mortality (all P<.0001 for trend). Patients with ≥3 metabolic risk factors, compared to those without metabolic risk factors, showed adjusted hazard ratios of 1.23 (95% confidence interval [CI], 1.16–1.31) for HCC, 1.34 (95% CI, 1.27–1.41) for non‐HCC cancer, and 1.31 (95% CI, 1.23–1.39) for all‐cause mortality. Among patients receiving antiviral therapy for over 5 years, the risk‐increasing association of the sum of metabolic risk factors with the risks of HCC and overall death was consistent.
Conclusion
The metabolic risk factor burden was associated with increased risks of HCC, non‐HCC cancer, and all‐cause mortality in patients with CHB.
논문정보
관련 링크
연구자 키워드
연구자 ID
관련분야 연구자보기
관련분야 논문보기
해당논문 저자보기