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Meta-Analysis
. 2012;17(11):1461-8.
doi: 10.1634/theoncologist.2012-0066. Epub 2012 Sep 6.

Body mass index and risk of primary liver cancer: a meta-analysis of prospective studies

Yuqin Wang  1 , Baochan Wang, Feng Shen, Jiangao Fan, Haixia Cao
Affiliations
Meta-Analysis

Body mass index and risk of primary liver cancer: a meta-analysis of prospective studies

Yuqin Wang et al. Oncologist. 2012.

Abstract

Background: Questions remain about the dose-response relationship between body mass index (BMI) and primary liver cancer (PLC) risk, possible confounding by hepatitis virus infection, and differences by gender or geographic location. We performed a meta-analysis of prospective studies to explore these issues.

Methods: We searched PubMed and Embase for studies of BMI and risk of PLC through November 30, 2011. Summary relative risks with their corresponding 95% confidence intervals (CIs) were calculated using a random effects model.

Results: A total of 21 prospective studies (including 17,624 PLC cases) were included in our analysis. The summary relative risk for a 5-unit increment in BMI (in kg/m(2)) was 1.39 (95% CI: 1.25-1.55), with high heterogeneity. These positive results were robust when stratified by sex, geographic location, ascertainment of exposure and outcome, the number of cases, duration of follow-up, sample source, and cofounders. There was evidence of a nonlinear association between BMI and PLC risk, with the most pronounced increase in risk among persons with a BMI >32 kg/m(2). Patients with hepatitis C virus or cirrhosis (but not patients with hepatitis B virus) with excess weight had a higher risk of PLC development than general populations with excess weight.

Conclusion: Excess weight increases PLC risk. For people with HCV infection or cirrhosis, risk increases are greater than for general population.

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Conflict of interest statement

Disclosures: The authors indicated no financial relationships.

Figures

Figure 1.
Figure 1.
Flow diagram of study selection. Abbreviation: HIV, human immunodeficiency virus.
Figure 2.
Figure 2.
Forest plots of risk of primary liver cancer associated with each 5-unit increase in BMI (in kg/m2). *Derived by pooling the sex-specific relative risks. **Derived from each 1-unit increment of body mass index. Abbreviations: CI, confidence interval; RR, relative risk.
Figure 3.
Figure 3.
Body mass index and primary liver cancer risk, nonlinear dose-risk relationship. Abbreviation: RR, relative risk.
See this image and copyright information in PMC

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