Obesity is known to be associated with primary liver cancer (PLC), but the separate effects of excess abdominal and gluteofemoral size are unclear. Thus, we examined the association between waist and hip circumference with risk of PLC overall and by histologic type—hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC). The Liver Cancer Pooling Project is a consortium of prospective cohort studies that include data from 1,167,244 individuals (PLC n = 2,208, HCC n = 1,154, ICC n = 335). Multivariable‐adjusted hazard ratios (HRs) and 95% confidence intervals (CI) were estimated using proportional hazards regression. Waist circumference, per 5 cm increase, was associated with an 11% increased PLC risk (HR = 1.11, 95%CI: 1.09–1.14), including when adjusted for hip circumference (HR = 1.12, 95%CI: 1.08–1.17) and also when restricted to individuals in a normal body mass index (BMI) range (18.5 to <25 kg/m²; HR = 1.14, 95%CI: 1.07–1.21). Hip circumference, per 5 cm increase, was associated with a 9% increased PLC risk (HR = 1.09, 95%CI: 1.06–1.12), but no association remained after adjustment for waist circumference (HR = 0.99, 95%CI: 0.94–1.03). HCC and ICC results were similar. These findings suggest that excess abdominal size is associated with an increased risk of liver cancer, even among individuals considered to have a normal BMI. However, excess gluteofemoral size alone confers no increased risk. Our findings extend prior analyses, which found an association between excess adiposity and risk of liver cancer, by disentangling the separate effects of excess abdominal and gluteofemoral size through utilization of both waist and hip circumference measurements.

中文翻译：

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腹部和臀股骨大小与肝癌风险：肝癌汇集项目。


已知肥胖与原发性肝癌 (PLC) 相关，但腹部和臀股骨过大的单独影响尚不清楚。因此，我们检查了腰围和臀围与整体 PLC 风险和组织学类型（肝细胞癌 (HCC) 和肝内胆管癌 (ICC)）之间的关系。肝癌汇集项目是一个前瞻性队列研究联盟，其中包括来自 1,167,244 名个体的数据（PLC n = 2,208、HCC n = 1,154、ICC n = 335）。使用比例风险回归估计多变量调整风险比 (HR) 和 95% 置信区间 (CI)。腰围每增加 5 厘米，PLC 风险就会增加 11%（HR = 1.11，95%CI：1.09–1.14），包括调整臀围时（HR = 1.12，95%CI：1.08–1.17）并且仅限于正常体重指数 (BMI) 范围内的个体（18.5 至 <25 kg/m ² ；HR = 1.14，95%CI：1.07–1.21）。臀围每增加 5 厘米，PLC 风险就会增加 9%（HR = 1.09，95%CI：1.06–1.12），但调整腰围后，两者之间没有关联（HR = 0.99，95%CI：0.94） –1.03）。 HCC 和 ICC 结果相似。这些发现表明，腹部过大与肝癌风险增加相关，即使对于体重指数正常的个体也是如此。然而，臀股骨过大本身并不会增加风险。我们的研究结果扩展了之前的分析，通过利用腰围和臀围测量来理清腹部和臀股尺寸过大的单独影响，发现过度肥胖与肝癌风险之间存在关联。