Obesity Linked to Increased Risk of Liver Cancer in Hepatitis B Patients

MedicalResearch.com Interview with:
Sang Min Park MD, MPH, PhD

Chief, Department of Family Medicine, Seoul National University College of Medicine
Director, Health Promotion Center, Seoul National University Hospital
Professor, Department of Biomedical Science & Family Medicine
Seoul National University College of Medicine
Seoul, Korea

What is the background for this study? What are the main findings?

Response: Chronic hepatitis B patients have a higher risk of hepatocellular carcinoma than the general population, which has been well-established and known to be caused by progression of hepatitis B infection into severe liver diseases.

However, whether obesity-related carcinogenesis plays a central role in the development of hepatocellular carcinoma in chronic hepatitis B patients remained unclear. Therefore, we assessed the association between body mass index and risk of hepatocellular carcinoma in chronic hepatitis B patients, and stratified all analyses by sex using healthcare big data in the Republic of Korea.

We found positive association of trends between body mass index and risk of hepatocellular carcinoma in both men and women with hepatitis B infection. The magnitude of the association in women was stronger than that of men. In the severely obese category, the hazard ratio for hepatocellular carcinoma was significantly higher in women compared to men. Our findings highlight that high body mass index is associated with risk of hepatocellular carcinoma in chronic hepatitis B patients, especially in women, which may be partially explained by higher fat content for the same unit of body mass index in women compared to men.

What should readers take away from your report?

Response: We found that high body mass index (more than 30kg/m2) is associated with an increased risk of hepatocellular carcinoma as compared to normal body mass index range (18.5-22.9 kg/m2) in patients with chronic hepatitis B infection. In patients with chronic hepatitis B infection, excessive accumulation of adipose tissue may lead to hepatocellular carcinoma because of increased levels of insulin secretion and inflammation. Based on our findings, we believe that physicians in the primary care should pay additional clinical attention to obese patients with chronic hepatitis B infection.

What recommendations do you have for future research as a result of this study?

Response: Additional research is necessary to confirm the findings of our study in other ethnic groups. Also, further studies should consider intervention strategies (e.g. on diet and physical activity) for obese patients with chronic hepatitis B infection to prevent hepatocellular carcinoma.

Is there anything else you would like to add? Any disclosures?

Response: Perhaps, our study needs to be examined a step further in the future when
additional medical data of chronic hepatitis B patients are available. For example, the healthcare big data used in our study lacks information on the viral DNA level of hepatitis B virus in each patient. Currently, laboratory assessment data are rarely available in healthcare big data. We do not have any conflict of interest for this study.


Kim K, Choi S, Park SM. Association of High Body Mass Index and Hepatocellular Carcinoma in Patients With Chronic Hepatitis B Virus InfectionA Korean Population-Based Cohort Study. JAMA Oncol. Published online March 22, 2018. doi:10.1001/jamaoncol.2018.0035


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