Association between metabolic abnormalities and HBV related hepatocelluar carcinoma in Chinese: a cross-sectional study

Abstract

Background: Previous studies suggested that the abnormality of metabolism is a newly identified risk factor in HBV-related hepatocellular carcinoma (HCC). The association between metabolic factors and hepatocellular carcinoma (HCC) has not been clarified up to now. This study was conducted to investigate the prevalence of metabolic abnormalities in HCC and to probe the association between metabolic parameters and liver function as well, so as to evaluate the interactions between metabolism and the development of HBV-related HCC.

Methods: Totally 179 cases of HBV-related HCC, who were surgically treated and pathologically confirmed were enrolled. HBV carriers (n = 100) and healthy controls (n = 150) were recruited from routine physical examination during the same period. Body mass index (BMI) was obtained from medical documentation. All the metabolic-related parameters and liver function tests were determined with routine biochemical or immunological analytic methods. Malondialdehyde (MDA) and total antioxidant capacity(TAOC)were detected by chemical analytic methods. A stratified analysis was conducted according to BMI, glycated albumin (GA), free fatty acids (FFA), and the relationships between the metabolic-related parameters and liver functions were analyzed in HCC and control subjects.

Results: HCC group showed significantly high levels of mean BMI, serum glucose, low serum lipids levels than controls (P < 0.05). Acquired by stratified analysis, the higher the BMI, the higher level of insulin and homeostasis model assessment for insulin resistance (HOMA-IR) (P < 0.01) were found in HCC patients. Elevated level of MDA and γ-glutamyltransferase (GGT) were revealed in those with high serum FFA level for the first time. Strong associations between metabolic factors and liver function were shown in HCC (P < 0.05). Higher GA level was strongly associated with increased risk of cancer compared to healthy controls (OR = 9.87, 95% confidence interval: 1.86~52.29). Serum triglycerides (TG) and low-density lipoprotein cholesterol (LDL-C) levels were negative contributory factors for HCC (OR = 0.05, 95% confidence interval: 0.01~0.27 and OR = 0.32, 95% confidence interval, 0.11~0.95: respectively).

Conclusions: Metabolic abnormalities are closely associated with the occurrence and development of HBV-related HCC. Oxidative stress and/or lipid peroxidation might be involved in the pathogenesis and acceleration of liver function impairments in HCC.

Figure 1

Metabolic parameters in healthy controls, HBV carriers and HCC. Totally 179 cases of patients with HBV-related HCC, 100 cases of HBV carriers and 150 cases of healthy controls were recruited. The liver function indicators and GA were measured on HITACHI 7600 automatic biochemical analyzer with matched reagents. Oxidative stress marker malondialdehyde (MDA) was measured using the thiobarbituric acid-reactive substances (TBARS) assay, total antioxidant capacity (TAOC) was measured with Fe³⁺ reduction method. HCC group showed significantly lower levels of TC, TG and higher levels of GA than both diseased and healthy controls (p < 0.01), while significantly higher levels of MDA and lower levels of TAOC were revealed in HCC (p < 0.01). LDL-C was higher in HCC than that in healthy controls (p < 0.01). Data were expressed as percentages ± standard error. * p value < 0.01 vs. control. Parametric variables were compared by post hoc analysis using Tukey test.