Chun Ho Soo, Park Sojeong, Lee Minjong, Cho Yuri, Kim Ha Sung, Choe A Reum, Kim Hwi Young, Yoo Kwon, Kim Tae Hun
Ewha Womans University Medical Center, Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul 07804, Korea.
Data Science Team, Hanmi Pharmaceutical Co., Ltd., Seoul 05545, Korea.
Cancers (Basel). 2021 Jul 8;13(14):3424. doi: 10.3390/cancers13143424.
In the general population, previous studies reported that physical activity was associated with risk of hepatocellular carcinoma (HCC) development. However, it is unclear whether physical activity is associated with risk of HCC development in patients with chronic hepatitis B (CHB). We aimed to elucidate the association between physical activity and risk of HCC development in CHB patients.
This nationwide cohort study involved treatment-naive patients with CHB ( = 9727) who started treatment with entecavir or tenofovir and answered self-reported questionnaires between January 2012 and December 2017, using data from the Korean National Health Insurance Service database. The primary endpoint was development of HCC. Multivariable Cox regression and competing risk analyses were used.
During a median follow-up of 3.1 years, cumulative HCC incidence rates were 8.3%. There was an inverse association between physical activity and the risk of HCC ( < 0.001). Patients with 1000-1500 metabolic equivalent task (MET)-min/week, compared to those without physical activity, showed a significantly lower risk of HCC in both patients without cirrhosis (adjusted hazard ratio [aHR] 0.66, = 0.02) and patients with cirrhosis (aHR 0.61, = 0.02). In patients who were younger (<60), male, without diabetes, and with high BMI, amounts of physical activity of 1000-1500 MET-min/week showed an inverse association with the risk of HCC (aHR 0.65, 0.63, 0.65, and 0.64, respectively, all < 0.05).
Physical activity was significantly associated with a low risk of HCC in CHB patients treated with entecavir or tenofovir.
在普通人群中，既往研究报告体力活动与肝细胞癌（HCC）发生风险相关。然而，体力活动是否与慢性乙型肝炎（CHB）患者的HCC发生风险相关尚不清楚。我们旨在阐明CHB患者体力活动与HCC发生风险之间的关联。
这项全国性队列研究纳入了初治的CHB患者（n = 9727），这些患者开始接受恩替卡韦或替诺福韦治疗，并于2012年1月至2017年12月期间回答了自我报告问卷，数据来自韩国国民健康保险服务数据库。主要终点是HCC的发生。采用多变量Cox回归和竞争风险分析。
在中位随访3.1年期间，HCC累积发病率为8.3%。体力活动与HCC风险呈负相关（P < 0.001）。与无体力活动者相比，每周代谢当量任务（MET）-分钟数为1000 - 1500的患者，无论有无肝硬化，HCC风险均显著降低（调整后风险比[aHR] 0.66，P = 0.02），有肝硬化的患者中也是如此（aHR 0.61，P = 0.02）。在年龄<60岁、男性、无糖尿病且BMI高的患者中，每周1000 - 1500 MET-分钟的体力活动量与HCC风险呈负相关（aHR分别为0.65、0.63、0.65和0.64，均P < 0.05）。
在接受恩替卡韦或替诺福韦治疗的CHB患者中，体力活动与低HCC风险显著相关。
