Abdominal obesity doubles liver cancer risk in CHB patients

Excessive accumulation of fat in the abdominal area contributes to a twofold increase in the risk of developing hepatocellular carcinoma (HCC) among chronic hepatitis B (CHB) patients being treated with antivirals, as shown in a study.

The analysis included 5,754 CHB patients who received nucleos(t)ide analogue medications. General obesity was assessed using body-mass index (BMI), while central obesity was assessed using waist circumference, waist-to-hip ratio, and waist-to-height ratio.

In the cohort, the cumulative incidence of HCC at 5 years was 2.9 percent. The incidence was significantly higher among patients with central obesity (defined as waist-to-height ratio >0.5) than those without excessive abdominal fat (3.9 percent vs 2.1 percent; hazard ratio [HR], 2.06; p=0.0001).

Results were similar in the propensity-score matched pairs of 745 individuals with central obesity and 745 of those without the condition (4.7 percent vs 2.3 percent; HR, 2.04; p=0.026). Central obesity was confirmed to have an independent association with HCC risk (HR, 1.63; p=0.013), in addition to cirrhosis status and aMAP HCC risk score.

Waist-to-height ratio had the best performance for predicting the development of HCC, as compared with BMI, waist circumference, or waist-to-hip ratio. Specifically, waist-to-height ratio gain within 1 year conferred an 88-percent risk increase (HR, 1.88, 95 percent confidence interval, 1.12–3.13; p=0.017).

The findings indicate that abnormal metabolic function plays an important role in the progression of liver disease.