Original Article
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Feb 21, 2011; 17(7): 914-921
Published online Feb 21, 2011. doi: 10.3748/wjg.v17.i7.914
Body mass index is associated with age-at-onset of HCV-infected hepatocellular carcinoma patients
Takumi Akiyama, Toshihiko Mizuta, Seiji Kawazoe, Yuichiro Eguchi, Yasunori Kawaguchi, Hirokazu Takahashi, Iwata Ozaki, Kazuma Fujimoto
Takumi Akiyama, Toshihiko Mizuta, Yuichiro Eguchi, Yasunori Kawaguchi, Hirokazu Takahashi, Iwata Ozaki, Kazuma Fujimoto, Department of Internal Medicine, Saga Medical School, Saga 8498501, Japan
Takumi Akiyama, Seiji Kawazoe, Department of Hepatology, Saga Prefectural Hospital, Saga 8408571, Japan
Author contributions: Akiyama T and Mizuta T designed research and analyzed data; Kawazoe S, Eguchi Y, Kawaguchi Y, Takahashi H and Ozaki I provided the patient data; Fujimoto K reviewed the manuscript; Akiyama T wrote the paper; Mizuta T reviewed and edited the manuscript.
Correspondence to: Toshihiko Mizuta, MD, PhD, Department of Internal Medicine, Saga Medical School, 5-1-1 Nabeshima, Saga 8498501, Japan. mizutat@med.saga-u.ac.jp
Telephone: +81-952-342362 Fax: +81-952-342017
Received: August 10, 2010
Revised: September 29, 2010
Accepted: October 6, 2010
Published online: February 21, 2011

AIM: To identify factors associated with the age at onset of hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC).

METHODS: Five hundred and fifty-six consecutive patients positive for HCV antibody and treatment-naïve HCC diagnosed between 1995 and 2004 were analyzed. Patients were classified into three groups according to age at HCC onset: < 60 years (n = 79), 60-79 years (n = 439), or ≥ 80 years (n = 38). Differences among groups in terms of sex, body mass index (BMI), lifestyle characteristics, and liver function were assessed. Factors associated with HCC onset in patients < 60 or ≥ 80 years were analyzed by logistic regression analysis.

RESULTS: Significant differences emerged for sex, BMI, degree of smoking and alcohol consumption, mean bilirubin, alanine aminotransferase (ALT), and γ-glutamyl transpeptidase (GGT) levels, prothrombin activity, and platelet counts. The mean BMI values of male patients > 60 years old were lower and mean BMI values of female patients < 60 years old were higher than those of the general Japanese population. BMI > 25 kg/m2 [hazard ratio (HR), 1.8, P = 0.045], excessive alcohol consumption (HR, 2.5, P = 0.024), male sex (HR, 3.6, P = 0.002), and GGT levels > 50 IU/L (HR, 2.4, P = 0.014) were independently associated with HCC onset in patients < 60 years. Low ALT level was the only factor associated with HCC onset in patients aged ≥ 80 years.

CONCLUSION: Increased BMI is associated with increased risk for early HCC development in HCV-infected patients. Achieving recommended BMI and reducing alcohol intake could help prevent hepatic carcinogenesis.

Keywords: Age-at-onset, Hepatocellular carcinoma, Hepatitis C virus, Body mass index, Alcohol consumption, Sex difference