Nakazawa Shoko, Fukai Kota, Sano Kei, Furuya Yuko, Hoshi Keika, Kojimahara Noriko, Toyota Akihiro, Korenaga Masaaki, Tatemichi Masayuki
Department of Preventive Medicine, Tokai University School of Medicine, Isehara, Japan.
Department of Preventive Medicine, Tokai University School of Medicine, Isehara, Japan
BMJ Open. 2025 Mar 12;15(3):e092020. doi: 10.1136/bmjopen-2024-092020.
While there is growing evidence that physical activity reduces the risk of hepatocellular carcinoma (HCC), the impact of occupational physical activity and sedentary behaviour remains unclear. This study aimed to investigate the associations between occupational physical activity and sedentary behaviour and HCC risk.
Matched case-control study.
Nationwide multicentre, hospital-inpatient data set in Japan, from 2005 to 2021.
The study included 5625 inpatients diagnosed with HCC and 27 792 matched controls without liver disease or neoplasms. Participants were matched based on sex, age, admission date, and hospital.
The association between levels of occupational physical activity (low, medium, high) and sedentary time (short, medium, long) with the risk of HCC.
Stratification of HCC risk by viral infection status (hepatitis B/C virus), alcohol consumption levels and the presence of metabolic diseases (hypertension, diabetes, dyslipidaemia, obesity).
High occupational physical activity was not associated with HCC caused by hepatitis B/C virus infection in men. In women, high occupational physical activity was associated with a reduced risk of non-viral HCC, with ORs (95% CIs) of 0.65 (0.45-0.93). Among patients with non-viral HCC, medium occupational physical activity combined with medium alcohol intake further decreased the HCC risk in men with an OR of 0.70 (0.50-0.97), while high occupational physical activity combined with lowest alcohol intake decreased the HCC risk in women with an OR of 0.69 (0.48-0.99). Men and women with medium sedentary time had a lower HCC risk compared with those with long sedentary time, with ORs of 0.88 (0.79-0.98) in men and 0.77 (0.62-0.97) in women, respectively. In patients without viral infection or alcohol use, medium sedentary time reduced the HCC risk associated with fatty liver disease without comorbid metabolic diseases in women.
High levels of occupational physical activity and/or medium periods of sedentary time are associated with a reduced risk of HCC, particularly non-alcoholic steatohepatitis.
虽然越来越多的证据表明体育活动可降低肝细胞癌（HCC）的风险，但职业体育活动和久坐行为的影响仍不明确。本研究旨在调查职业体育活动和久坐行为与HCC风险之间的关联。
配对病例对照研究。
2005年至2021年日本全国多中心医院住院数据集。
该研究纳入了5625例被诊断为HCC的住院患者和27792例匹配的无肝病或肿瘤的对照者。参与者根据性别、年龄、入院日期和医院进行匹配。
职业体育活动水平（低、中、高）和久坐时间（短、中、长）与HCC风险之间的关联。
根据病毒感染状态（乙型/丙型肝炎病毒）、饮酒水平和代谢疾病（高血压、糖尿病、血脂异常、肥胖）的存在对HCC风险进行分层。
男性中，高职业体育活动与乙型/丙型肝炎病毒感染引起的HCC无关。在女性中，高职业体育活动与非病毒性HCC风险降低相关，比值比（95%置信区间）为0.65（0.45 - 0.93）。在非病毒性HCC患者中，中等职业体育活动与中等酒精摄入量相结合，进一步降低了男性的HCC风险，比值比为0.70（0.50 - 0.97），而高职业体育活动与最低酒精摄入量相结合，降低了女性的HCC风险，比值比为0.69（0.48 - 0.99）。与久坐时间长的男性和女性相比，久坐时间中等的男性和女性HCC风险较低，男性的比值比为0.88（0.79 - 0.98），女性为0.77（0.62 - 0.97）。在没有病毒感染或饮酒的患者中，中等久坐时间降低了女性非酒精性脂肪性肝病合并代谢疾病的HCC风险。
高水平的职业体育活动和/或中等时长的久坐时间与HCC风险降低相关，尤其是非酒精性脂肪性肝炎。
