Division of Gastroenterology & Liver Unit, University of Alberta Hospital, Edmonton, Alberta, Canada.
Division of Human Nutrition, University of Alberta, Edmonton, Alberta, Canada.
Hepatology. 2018 Mar;67(3):914-923. doi: 10.1002/hep.29578. Epub 2018 Jan 26.
Visceral adipose tissue (VAT) is a metabolically active organ, associated with higher risk of malignancies. We evaluated whether VAT is associated with the risk of hepatocellular carcinoma (HCC) in patients presenting with cirrhosis as well as HCC recurrence after liver transplantation (LT). Patients with cirrhosis (n = 678; 457 male) who were assessed for LT (289 with HCC) were evaluated for body composition analysis. Patients who underwent LT (n = 247, 168 male) were subsequently evaluated for body composition, and 96 of these patients (78 male) had HCC. VAT, subcutaneous adipose tissues, and total adipose tissues were quantified by computed tomography at the level of the third lumbar vertebra and reported as indexes (cross-sectional area normalized for height [square centimeters per square meter]). At the time of LT assessment, the VAT index (VATI) was higher in male patients with HCC compared to non-HCC patients (75 ± 3 versus 60 ± 3 cm /m , P = 0.001). The VATI, subcutaneous adipose tissue index, and total adipose tissue index were higher in male patients with HCC compared to non-HCC patients. By multivariate analysis, male patients with VATI ≥65 cm /m had a higher risk of HCC (hazard ratio, 1.90; 95% confidence interval, 1.31-2.76; P = 0.001). In male patients with HCC who underwent LT, a VATI ≥65 cm /m adjusted for Milan criteria was independently associated with higher risk of HCC recurrence (hazard ratio, 5.34; 95% confidence interval, 1.19-23.97; P = 0.03).
High VATI is an independent risk factor for HCC in male patients with cirrhosis and for recurrence of HCC after LT. (Hepatology 2018;67:914-923).
内脏脂肪组织（VAT）是一种代谢活跃的器官，与更高的恶性肿瘤风险相关。我们评估了在患有肝硬化的患者中，VAT 是否与肝细胞癌（HCC）的风险相关，以及在肝移植（LT）后 HCC 的复发。评估了 678 例（457 例男性）接受 LT （289 例 HCC）的肝硬化患者的身体成分分析。随后，对接受 LT 的 247 例患者（168 例男性）进行了身体成分评估，其中 96 例（78 例男性）患有 HCC。通过 CT 在第三腰椎水平量化 VAT、皮下脂肪组织和总脂肪组织，并报告为指数（平方厘米/平方米的横截面积归一化）。在 LT 评估时，与非 HCC 患者相比，男性 HCC 患者的 VAT 指数（VATI）更高（75 ± 3 与 60 ± 3 cm /m ，P = 0.001）。与非 HCC 患者相比，男性 HCC 患者的 VATI、皮下脂肪组织指数和总脂肪组织指数更高。通过多变量分析，VATI ≥65 cm /m 的男性 HCC 患者 HCC 的风险更高（危险比，1.90；95%置信区间，1.31-2.76；P = 0.001）。在接受 LT 的男性 HCC 患者中，VATI≥65 cm /m 且符合米兰标准调整后的 HCC 复发风险更高（危险比，5.34；95%置信区间，1.19-23.97；P = 0.03）。
高 VATI 是男性肝硬化患者 HCC 以及 LT 后 HCC 复发的独立危险因素。（Hepatology 2018；67：914-923）。
