Plasma Adipokines and Risk of Hepatocellular Carcinoma in Chronic Hepatitis B Virus-Infected Carriers: A Prospective Study in Taiwan

C.-L. Chen, W.-S. Yang, H.-I. Yang, C.-F. Chen, S.-L. You, L.-Y. Wang, S.-N. Lu, C.-J. Liu, J.-H. Kao, P.-J. Chen, D.-S. Chen, C.-J. Chen
2014 Cancer Epidemiology, Biomarkers and Prevention  
Obesity is considered a risk factor for hepatocellular carcinoma (HCC). The relationship between adipocytokine and HCC in hepatitis B virus (HBV) carriers remains unclear. We prospectively investigated the association of adiponectin, leptin, and visfatin levels with HCC. Methods: We conducted a nested case-control study in a community-based cohort with 187 incident HCC and 374 HCC-free HBV carriers. Unconditional logistic regression was conducted to estimate the ORs and 95% confidence intervals
more » ... (CI). Results: Adiponectin, but not leptin and visfatin, levels were associated with an increased risk of HCC after adjustment for other metabolic factors and HBV-related factors. The risk was increased [OR ¼ 0.51; 95% CI, 0.12-2.11; 3); OR ¼ 3.79 (1.10-13.0); OR ¼ 4.13 (1.13-15.1) with each additional quintiles, respectively] with a significant dose-response trend (P trend ¼ 0.003). HCC risk associated with higher adiponectin level was higher in HBV carriers with ultrasonographic fatty liver, genotype C infection, higher viral load, and with elevated alanine aminotransferase. Longitudinally, participants with higher adiponectin were less likely to achieve surface antigen of hepatitis B virus (HBsAg) seroclearance and more likely to have persistently higher HBV DNA. Eventually, they were more likely to develop liver cirrhosis [OR ¼ 1.65 (0.62-4.39); OR ¼ 3.85 (1.47-10.1); OR ¼ 2.56 (0.96-6.84); OR ¼ 3.76 (1.33-10.7) for the second, third, fourth, and fifth quintiles, respectively; P trend ¼ 0.017] before HCC. Conclusions: Elevated adiponectin levels were independently associated with an increased risk of HCC. Impact: Adiponectin may play different roles in the virus-induced and metabolic-related liver diseases, but the underlying mechanism remains unknown. Cancer Epidemiol Biomarkers Prev; 23(8); 1659-71. Ó2014 AACR.
doi:10.1158/1055-9965.epi-14-0161 pmid:24895413 fatcat:6qd5mnvl4bedbl7faksnx2da4q