University of Cambridge, Addenbrooke's Hospital, UK.
Aliment Pharmacol Ther. 2010 May;31(10):1051-63. doi: 10.1111/j.1365-2036.2010.04271.x. Epub 2010 Feb 18.
Evidence increasingly implicates obesity as an independent risk factor for different cancers. We examined such evidence for hepatocellular carcinoma.
To review the effect of increased levels of body mass index on hepatocellular carcinoma risk.
We reviewed systematically the literature examining the association between increased body mass index and hepatocellular carcinoma risk. For each identified study, relevant data were extracted and appraised.
Ten cohort studies (>90 million person-years), one nested case-control study (244 cases) and two case-control studies (494 cases) were identified. Of the cohort studies, 75% of person-years related to North Americans, 15% to East Asians, and 10% to Europeans. Three cohort studies adjusted for alcohol consumption, only one cohort study adjusted for hepatitis infection status. Seven cohort studies found a positive association between obesity (body mass index > or =30 kg/m(2)) and hepatocellular carcinoma risk (relative risks ranging from 1.4 to 4.1); two reported no association; and one reported a significant inverse association for a population subgroup (relative risk = 0.7, 95% confidence interval: 0.5-0.9).
Although most studies did not adjust for confounders and most data relate to a single world region, the overall evidence is suggestive of an increased hepatocellular carcinoma risk in obese and overweight individuals.
越来越多的证据表明肥胖是多种癌症的独立危险因素。我们研究了肥胖与肝细胞癌之间的关系。
综述体重指数升高与肝细胞癌风险之间的关系。
我们系统地回顾了研究体重指数与肝细胞癌风险之间关系的文献。对每一项确定的研究，提取并评估了相关数据。
共纳入 10 项队列研究（>9000 万人年）、1 项巢式病例对照研究（244 例）和 2 项病例对照研究（494 例）。其中 75%的人年资料来源于北美人群，15%来源于东亚人群，10%来源于欧洲人群。有 3 项队列研究调整了饮酒因素，仅有 1 项队列研究调整了肝炎感染状态。7 项队列研究发现肥胖（体重指数>或=30kg/m2）与肝细胞癌风险之间存在正相关（相对危险度范围为 1.44.1）；2 项研究报道两者之间无关联；有 1 项研究报道在某个人群亚组中存在显著的负相关（相对危险度=0.7，95%可信区间：0.50.9）。
虽然大多数研究未调整混杂因素，且大多数数据仅来源于单一的世界区域，但总体证据表明肥胖和超重与肝细胞癌风险增加相关。
