AP&T: 慢性乙型肝炎抗病毒治疗患者中心性肥胖与肝细胞癌的关系

2021-07-15 MedSci原创 MedSci原创

肝细胞癌 (HCC) 是导致慢性乙型肝炎 (CHB) 患者死亡的主要原因,目前的抗病毒药物不能完全阻止 HCC的发生。

      肝细胞癌 (HCC) 是导致慢性乙型肝炎 (CHB) 患者死亡的主要原因,目前的抗病毒药物不能完全阻止 HCC的发生,以前的研究报道也证实代谢综合征,尤其是肥胖、肝脂肪变性、高血压、糖尿病和血脂异常与HCC 的风险增加显著相关。肥胖症通常被视为代谢综合征的一种表现,在发达国家和发展中国家都在迅速增加。而目前,尚未有研究对接受抗病毒治疗CHB 进行肥胖与HCC发生率关系的研究。

 

      为此,研究人员将来自中国多中心、前瞻性、观察性、接受治疗的 CHB 队列的患者组成了一项队列研究。肥胖是通过体重指数(BMI)来评估的,中心性肥胖通过腰围、腰臀比和腰高比来评价。

 

      共有 5754 名接受核苷(酸)类似物治疗的CHB患者参与了本项研究。HCC 的 5 年累积发病率为 2.9%。腰高比在预测 HCC 发展方面的表现优于 BMI、腰围或腰臀比。在总体人群中,中心性肥胖患者(定义为腰高比 >0.5)的 5 年 HCC 发病率显着高于非中心性肥胖患者(3.9% vs 2.1%,风险比 [HR]:2.06,P= 0.0001) ,这样的现象在 745 个倾向得分匹配对象中也得到了确认(4.7% vs 2.3%,HR:2.04,P= 0.026)。除了肝硬化状态外,向心性肥胖也与 HCC 风险独立相关(HR:1.63,P = 0.013)。1 年内腰围与身高比增加与显着更高的 HCC 风险相关,调整后的 HR 值为 1.88(95% 置信区间:1.12-3.13,P= 0.017)。

图:肥胖与肝细胞癌的关系

      本项研究证实在接受抗病毒治疗的 CHB 患者中,通过腰高比评估的向心性肥胖与 HCC 风险增加两倍有关,突出了代谢功能异常在肝病进展中的重要作用。

 

 

原始出处:

Rong Fan. Et al. Association of central obesity with hepatocellular carcinoma in patients with chronic hepatitis B receiving antiviral therapy. Alimentary Pharmacology & Therapeutics.2021.

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    2022-06-25 xjy02
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    2021-07-17 yahu
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    2021-07-16 ms2658711348342440

    谢谢 学习了

    0

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    2021-07-16 可爱的洪水猛兽

    学习

    0

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