Body Mass Index, Diabetes and Intrahepatic Cholangiocarcinoma Risk: The Liver Cancer Pooling Project and Meta-analysis.
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Petrick Jessica L, Thistle Jake E, Zeleniuch-Jacquotte Anne, Zhang Xuehong, Wactawski-Wende Jean, Van Dyke Alison L, Stampfer Meir J, Sinha Rashmi, Sesso Howard D, Schairer Catherine, Rosenberg Lynn, Rohan Thomas E, Robien Kim, Purdue Mark P, Poynter Jenny N, Palmer Julie R, Newton Christina C, Linet Martha S, Liao Linda M, Lee I-Min, Koshiol Jill, Kitahara Cari M, Hofmann Jonathan N, Graubard Barry I, Giovannucci Edward, Gaziano Michael J, Gapstur Susan M, Freedman Neal D, Chong Dawn Q, Chan Andrew T, Buring Julie E, Freeman Laura Beane E, Campbell Peter T, McGlynn Katherine A
Аннотация
DESIGN: For the pooled analysis, we utilized the Liver Cancer Pooling Project, a consortium of 13 US-based, prospective cohort studies with data from 1,541,143 individuals (ICC cases n = 414). In our systematic review, we identified 14 additional studies. We then conducted a meta-analysis, combining the results from LCPP with results from the 5 prospective studies identified through September 2017.
RESULTS: In the LCPP, obesity and diabetes were associated with a 62% [Hazard Ratio (HR) = 1.62, 95% Confidence Interval (CI): 1.24-2.12] and an 81% (HR = 1.81, 95% CI: 1.33-2.46) increased ICC risk, respectively. In the meta-analysis of prospectively ascertained cohorts and nested case-control studies, obesity was associated with a 49% increased ICC risk [Relative Risk (RR) = 1.49, 95% CI: 1.32-1.70; n = 4 studies; I2 = 0%]. Diabetes was associated with a 53% increased ICC risk (RR = 1.53, 95% CI: 1.31-1.78; n = 6 studies). While we noted heterogeneity between studies (I2 = 67%) for diabetes, results were consistent in subgroup analyses. Results from hospital-based case-control studies (n = 9) were mostly consistent, but these studies are potentially subject to reverse causation.
CONCLUSIONS: These findings suggest that obesity and diabetes are associated with increased ICC risk, highlighting similar etiologies of hepatocellular carcinoma and intrahepatic cholangiocarcinoma. However, additional prospective studies are needed to verify these associations.