Body-mass index and progression of hepatitis B: a population-based cohort study

StephenW

http://www.ncbi.nlm.nih.gov/pubmed/18955457
J Clin Oncol. 2008 Dec 1;26(34):5576-82. Epub 2008 Oct 27.
Body-mass index and progression of hepatitis B: a population-based cohort study in men.
Yu MW, Shih WL, Lin CL, Liu CJ, Jian JW, Tsai KS, Chen CJ.
Source

Graduate Institute of Epidemiology, College of Public Health, National Taiwan University, Room 522, No.17, Xuzhou Rd, Zhongzheng District, Taipei City 10055, Taiwan. [email protected]
Abstract
PURPOSE:

To determine prospectively whether body-mass index (BMI) is associated with liver-related morbidity and mortality among male hepatitis B virus (HBV) carriers.
PATIENTS AND METHODS:

We performed a prospective study of 2,903 male HBV surface antigen-positive government employees who were free of cancer at enrollment between 1989 and 1992. Main outcome measures included ultrasonography, biochemical tests, incident hepatocellular carcinoma (HCC), and liver-related death.
RESULTS:

During mean follow-up of 14.7 years, 134 developed HCC and 92 died as a result of liver-related causes. In Cox proportional hazards models adjusting for age, number of visits, diabetes, and use of alcohol and tobacco, the hazard ratios for incident HCC were 1.48 (95% CI, 1.04 to 2.12) in overweight men (BMI between 25.0 and 29.9 kg/m(2)) and 1.96 (95% CI, 0.72 to 5.38) in obese men (BMI >or= 30.0 kg/m(2)), compared with normal-weight men (BMI between 18.5 and 24.9 kg/m(2)). Liver-related mortality had adjusted hazard ratios of 1.74 (95% CI, 1.15 to 2.65) in overweight men and 1.50 (95% CI, 0.36 to 6.19) in obese men. Excess BMI was also associated with the occurrence of fatty liver and cirrhosis detected by ultrasonography, as well as elevated ALT and gamma-glutamyltransferase (GGT) activity during follow-up. The association of BMI with GGT was stronger than with ALT, and elevated GGT activity and cirrhosis were the strongest predictors for incident HCC and liver-related death.
CONCLUSION:

This longitudinal cohort study indicates that excess body weight is involved in the transition from healthy HBV carrier state to HCC and liver-related death among men.

StephenW

参考治疗： 2008年12月1日; 26（34）:5576 - 82。作者2008年10月27日。
身体质量指数和B型肝炎的进展：在男性人口为基础的队列研究。
于兆瓦，施WL，林CL，刘CJ -，建JW，蔡金水，陈终审法院首席法官。
来源

流行病学研究所，公共卫生学院，国立台湾大学，522室，17号，徐州路，中正区，台北市10055，台湾。 [email protected]
摘要
目的：

为了身体质量指数（BMI）是否与肝脏相关的发病率和死亡率之间的男性B型肝炎病毒（HBV）携带者的关联，确定前瞻性。
病人与方法：

我们进行了一项前瞻性研究，2903男性乙型肝炎表面抗原阳性的政府雇员在1989年和1992年之间的报名癌症。主要成果的措施，包括B超，生化检验，事件肝细胞癌（HCC）和肝有关的死亡。
结果：

在平均随访14.7年，134开发的肝癌和92肝有关的原因而死亡。在Cox比例风险模型调整年龄，访问次数，糖尿病，并使用酒精和烟草，事件发生肝癌的危险率分别为1.48超重男子（BMI在25.0和29.9公斤/之间（95％CI，1.04至2.12）米（2））和1.96（在肥胖男性，95％CI 0.72〜5.38）（BMI>或= 30.0公斤/米（2）），比体重正常的男性（体重指数在18.5至24.9公斤/米（2之间））。肝脏相关死亡率已调整危险比为1.74（95％CI，1.15〜2.65）在超重男性肥胖男性和1.50（95％CI，0.36〜6.19）。多余的体重指数也与超声检测脂肪肝和肝硬化的发生，以及ALT升高，γ-谷氨酰转肽酶（GGT）的活性，在后续。协会的BMI与GGT的强比用ALT，GGT升高的活动和肝硬化事件肝癌和肝有关的死亡最强的预测。
结论：

这种纵向队列研究表明，过量的体重是男人之间的过渡，从健康的乙肝病毒携带状态，肝癌和肝有关的死亡。