Correlation Study Of Metabolic Syndrome And Primary Hepatocellular Carcinoma

Objective: 1.To investigate the impact of metabolic syndrome and metabolic syndrome related components on the risk of hepatocellular carcinoma.2.Clinical features of hepatocellular carcinoma in the background metabolic syndrome.Methods: We enrolled 1258 cases of patients diagnosed with hepatocellular carcinoma for the first time,who had lived in The First Hospital of Jilin University during January 2012 to September 2016.Controls were patients admitted to the same hospitals for a wide spectrum of acute,non-neoplastic conditions.We collected the patients' data,such as,gender,age,family,history,clinical symptoms,laboratory tests and imaging examination.we conducted a case-control study and the statistics were analyzed by the spss22.0 software.Results: The part one: the impact of metabolic syndrome and metabolic syndrome related components on the risk of hepatocellular carcinoma 1.Prevalences of metabolic syndrome in the five groups(HBV related hepatocellular related hepatocellular carcinoma,HCV related hepatocellular carcinoma,HBV/HCV related hepatocellular carcinoma,alcohol related hepatocellular carcinoma,cryptogenic hepatocellular carcinoma with metabolic syndrome)were: 23.1%?30.9%?23.8%?35.3%?50%?.respectively in the cases.The prevalence of metabolic syndrome in the cryptogenic hepatocellular carcinoma group was the highest,while the prevalence of metabolic syndrome in the HBV related hepatocellular carcinoma group was the lowest.The levels of blood pressure,blood glucose and HDL-C were significant differences among the five groups,respectively.The prevalence of the number of MS components were significant differences among the five groups.2.In case group the prevalence of metabolic syndrome(24.9%)was higher than control group(16.9%).the two group was significant difference.And the prevalence of metabolic syndrome in case group no matter man(24.9% VS 17.7%)or woman(24.9% VS 13.5%)were higher than control group.3.Univariate analysis found that chronic hepatitis B,chronic hepatitis C,drinking,smoking were statistically significant differences respectively(p<0.05).The metabolic syndrome and metabolic components associated with the metabolic syndrome in univariate analys is found that diabetes(OR=2.15,95%Cl: 1.67~2.76,p<0.001),obesity(BMI?25kg/m2)(OR=1.69,95%Cl:1.44~1.99,p<0.001),the metabolic syndrome(OR=1.63,95%Cl:1.36~1.90,p<0.001),and Low HDL-C(OR=1.68,95%Cl:1.32~2.16,p<0.001)were statistically significant differences respectively.but,high blood pressure,high triglycerides were no statistical differences(P> 0.05).4.Multivariate analysis which adjust for HBV,HCV,drinking and smoking found that diabetes(OR=2.70,95%Cl:1.87~3.90,p<0.001),obesity(BMI?25kg/m2)(OR=1.79,95%Cl:1.30~2.47,p=0.001),metabolic syndrome(OR=1.77,95%Cl:1.23~ 2.54,p=0.002)were statistically significant differences respectively.and found that the risk increased with the number of MS related metabolic components1MS(OR=1.33),2MS(OR=1.39)3MS(OR=2.32),the trend values p=0.001.5.Adjusting for gender,age,residence,smoking and drinking found that only obesity(OR=1.65,95%Cl:1.07~2.55,p=0.027)was statistical difference for the HBV related hepatocellular carcinoma.but for the HCV related hepatocellular carcinoma and hepatocellular carcinoma without markers of chronic infection with HBV and/or HCV,obesity,diabetes,MS were statistically significant differences,and the risk increased with the number of MS related metabolic components.The second part: Clinical features of hepatocellular carcinoma in the background metabolic syndrome 1.General characteristics: the case group divided into two groups which is MS and non-MS group.Urban residents in MS group(50.2%)was significantly higher than non-MS group(36.0%),(p<0.05).Between MS and non-MS group the proportion of different causes of hepatocellular carcinoma was statistically significant(p<0.05).2.Laboratory examination and imaging examination:In MS group ALT,ALP,GGT,BILI level was significantly higher than non-MS group,and albumin level is lower than the non-MS group(p<0.05).The tumor diameter and ascites were statistically difference between the two groups.In the MS group,the tumor diameter which is 5 to 10 centimeter was more than non-MS group(p<0.05).3.In MS group,the proportion of Child-Pugh class B and C were significantly higher than the non-MS group(61%VS49.5),And the proportion of BCLC stage C and D were significantly higher than the non-MS group(56.5%VS44.8%).Conclusion: The metabolic syndrome,diabetes and obesity can increase the risk of non-viral hepatocellular carcinoma HCV related hepatocellular carcinoma.They are likely to be the risk factors for hepatocellular carcinoma,and the risk of hepatocellular carcinoma increased with the number of MS related metabolic components.