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Impact of overweight and obesity on the risk of hepatocellular carcinoma: a prospective cohort study in 14.3 million Koreans

Menée en Corée auprès de 14 265 822 adultes (durée moyenne de suivi : 13,7 ans), cette étude analyse l'association entre l'indice de masse corporelle et le risque de carcinome hépatocellulaire (47 308 cas)

Background: Whether obesity and being overweight, defined by body mass index (BMI), increase hepatocellular carcinoma (HCC) has been less apparent in Asian populations. Methods: Overall, 14,265,822 Korean adults who underwent routine health examinations during 2003–2006 were followed up for HCC. Multivariable-adjusted hazard ratios (HRs) associated with BMI were calculated. Results: During 13.7 years (mean) of follow-up, 47,308 individuals developed HCC. HRs of HCC associated with BMIs of 25.0–26.4, 26.5–27.9, 28.0–29.4, 29.5–30.9 and ≥31 kg/m² compared to those for 23.5–24.9 kg/m² were 1.05, 1.20, 1.39, 1.59 and 2.13, respectively. For BMI < 25 kg/m², linear associations were not apparent. For BMI ≥ 25 kg/m2, the HR per 5 kg/m2 increase in BMI was 1.60 (total), 1.60 (men), and 1.59 (women). The corresponding HRs were 1.56, 1.61 and 1.60 for individuals aged <45, 45–64 and ≥65 years, respectively. Further adjustment for alanine transaminase (ALT) levels substantially reduced the HRs for high BMI, especially in men and younger adults. Conclusions: Overweight and obesity clearly increase HCC risk in Koreans. ALT levels are a mediator of the impact of obesity, but it may not accurately predict high BMI-induced liver damage that can potentially progress to HCC, especially in women and older adults.

British Journal of Cancer

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