Data from Adiposity, Adulthood Weight Change, and Risk of Incident Hepatocellular Carcinoma

Abstract

Prospective data are limited regarding dynamic adulthood weight changes and hepatocellular carcinoma (HCC) risk. We included 77,238 women (1980–2012) and 48,026 men (1986–2012), who recalled young-adult weight [age 18 years (women); 21 years (men)], and provided biennially updated information regarding weight, body mass index (BMI), and comorbidities. Overall adulthood weight change was defined as the difference in weight (kilograms) between young-adulthood and present. Using Cox proportional hazards models, we calculated multivariable adjusted HRs (aHR) and 95% confidence intervals (CI). Over 3,676,549 person-years, we documented 158 incident HCC cases. Elevated HCC risk was observed with higher BMI in both young-adulthood and later-adulthood [continuous aHRs per each 1 unit = 1.05; 95% CI = 1.02–1.09 (P_trend = 0.019), and 1.08; 95% CI = 1.06–1.10 (P_trend = 0.004), respectively]. Moreover, overall adulthood weight gain was also significantly associated with increased HCC risk (aHR per each 1-kg increase = 1.03; 95% CI = 1.01–1.08; P_trend = 0.010), including after further adjusting for young-adult BMI (P_trend = 0.010) and later-adult BMI (P_trend = 0.008). Compared with adults with stable weight (±5 kg), the multivariable-aHRs with weight gain of 5–<10 kg, 10–<20 kg, and ≥20 kg were, 1.40 (95% CI = 0.67–2.16), 2.09 (95% CI = 1.11–3.95), and 2.61 (95% CI = 1.42–5.22), respectively. In two prospective, nationwide cohorts, adulthood weight gain was significantly associated with increased HCC risk.

Prevention Relevance:

Our data suggest that maintaining a stable weight during adulthood, specifically by preventing weight gain, could represent an important public health strategy for the prevention of hepatocellular carcinoma.