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- 저자 : ( Fabien Zoulim ) (검색결과 1 건)
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( Yun Bin Lee ),( Hyemi Moon ),( Jeong-hoon Lee ),( Eun Ju Cho ),( Su Jong Yu ),( Yoon Jun Kim ),( Fabien Zoulim ),( Juneyoung Lee ),( Jung-Hwan Yoon ) 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1
Aims: Long-term antiviral therapy can effectively suppress viral replication and improve clinical outcomes in chronic hepatitis B patients, but it cannot eliminate the risk of hepatocellular carcinoma (HCC). We investigated the association of metabolic risk factors with the risks of cancer and all-cause mortality in chronic hepatitis B patients using the Korean National Health Insurance Service database. Methods: We collected baseline data on metabolic risk factors, including obesity, hypercholesterolemia, insulin resistance, and hypertension. The risks of developing HCC, non-HCC cancer, and overall death were analyzed according to the metabolic risk profile. The risks of HCC and non-HCC cancer were analyzed after adjusting death as a competing risk event. Results: The study population consisted of 317,856 adults with chronic hepatitis B. A total of 18,850 HCCs, 22,164 non-HCC cancers, and 15,768 deaths were observed during a median follow-up period of 8.5 years. The cumulative incidences of HCC (P<.0001; panel A), non-HCC cancer (P<.0001; panel B), and death (P<.0001; panel C) rose with increasing number of metabolic factors. The metabolic risk factor burden was positively associated with the risks of HCC, non-HCC cancer, and all-cause mortality (all P<.0001 for trend). Patients with ≥3 metabolic risk factors, compared to those without metabolic risk factors, showed adjusted hazard ratios of 1.23 (95% confidence interval [CI], 1.16-1.31) for HCC, 1.34 (95% CI, 1.27-1.41) for non-HCC cancer, and 1.31 (95% CI, 1.23-1.39) for all-cause mortality. Among patients receiving antiviral therapy for over 5 years, the risk-increasing association of the sum of metabolic risk factors with the risks of HCC and overall death was consistent. Conclusions: In this Korean nationwide cohort study, the burden of metabolic risk factors was associated with increased risk of HCC, non-HCC cancer, and all-cause mortality in patients with chronic HBV infection.
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