Results from a recent study published in the journal Gastroenterology, entitled “Obesity Early in Adulthood Increases Risk but Does Not Affect Outcomes of Hepatocellular Carcinoma,” revealed that people who were obese in early adulthood had an increased risk for developing hepatocellular carcinoma later on. Epidemiological studies have shown that obesity is a risk factor for hepatocellular carcinoma.

“To investigate the association between [hepatocellular carcinoma] and obesity before [hepatocellular carcinoma] development, we embarked on a large case-control study in which we integrated clinical and epidemiologic data with obesity data to assess … the independent effect of excess body weight across an individual’s life cycle on [hepatocellular carcinoma] risk, the synergistic interaction between obesity and other [hepatocellular carcinoma] risk factors and the effect of obesity on age at [hepatocellular carcinoma] onset or on overall survival rate of [hepatocellular carcinoma] patients,” the researchers wrote according to a recent news release.

The team of researchers cross-examined from 2004 to 2013 a total of 622 patients with a recent HCC diagnosis. Data was compared in a control cohort of 660 healthy individuals with the aim of determining weights, heights, and body sizes (self-reported) at various ages before HCC development or enrollment as controls.

To determine the independent effects of early obesity on risk for HCC and patient outcomes, respectively the researchers used multivariate analysis. The researchers also measured BMI and a BMI of or greater than 30 kg/m2 was considered obese.

The results showed that obesity in early adulthood (mid-20s to mid-40s) in both men and women was associated with an increased risk of HCC development and with early onset of HCC, regardless of the confounding effects of the established risk factors of HCC such as HCV, HBV, alcohol consumption, cigarette smoking, and diabetes mellitus.

There was an association between each unit increase in BMI at early adulthood and a 3.89-month decrease in age at HCC diagnosis. The results also revealed a synergistic interaction between obesity and hepatitis virus infection. However, there was no effect of obesity on the overall survival of HCC patients.

“A prior history of obesity in the mid-20s, mid-30s and mid-40s was associated significantly with an increased HCC risk in the whole study population and in the absence of major HCC risk factors,” the researchers wrote.

The researchers concluded: “This study provides robust epidemiologic evidence to support the association between obese adults in their mid-20s to mid-40s and risk of HCC in American men and women, with obese subjects more susceptible than non-obese subjects to early onset HCC,” the researchers concluded. “Educational interventions and public awareness may be key to reducing the incidence of obesity at a young age. Behavioral modification, including abstaining from alcohol and restricting diet, especially among patients with chronic viral infection, may reduce the incidence of end-stage [chronic liver diseases].”

The researchers suggest that future investigation of the preventive and favorable prognostic role of metformin and statin in patients with CLDs, including HCC, should be initiated.