Overweight and Obesity as Independent Factors for Increased Risk of Hepatocellular Cancer-Related Mortality: A Meta-Analysis

Abstract

Obesity is related to the amplified risk of developing hepatocellular cancer, but its outcome on hepatocellular cancer-related mortality remains uncertain. Hence, the present study aimed to perform a meta-analysis study to evaluate the relationship between weight and hepatocellular cancer-related deaths. Through a systematic literature search up to December 2019, 7 observational studies with 2,349,834 subjects, 4834 hepatocellular cancer-related deaths were identified reporting relationships between body mass index (BMI), and hepatocellular cancer-related mortality. Odd ratio (OR) with 95% confidence intervals (CIs) was calculated comparing obese, BML > 30kg/m², and overweight, BMI, 25–29.9 kg/m² to subjects with normal BMI using the dichotomous method with a random-effect model. In obese subjects, males (OR, 1.84; 95% CI, 1.25–2.70) and females (OR, 1.26; 95% CI, 1.11–1.44), had higher hepatocellular cancer-related mortality compared to normal BMI subjects. However, overweight males (OR, 1.12; 95% CI, 0.98–1.28) and overweight females (OR, 1.06; 95% CI, 0.95–1.18), did not have such risk with moderate heterogeneity. The extent of increased mortality was higher in obese males compared to obese females. The impact of obesity on hepatocellular cancer-related mortality was observed in all populations with less extant in the black population. Based on this meta-analysis, obesity may have an independent relationship with up to the 1.84-fold risk of hepatocellular cancer-related mortality. This relationship was more pronounced in males than in females.

Key teaching points

• Being overweight is related to the amplified risk of developing hepatocellular cancer.

• Obesity's affect on hepatocellular cancer-related mortality remains uncertain.

• Based on this meta-analysis, obesity may have an independent relationship with up to the 1.84-fold risk of hepatocellular cancer-related mortality.

• This relationship was more pronounced in males than in females.

Keywords:

• Obesity
• overweight
• body mass index
• premorbid
• hepatocellular cancer
• mortality
• prognosis

Acknowledgments

We must thank Professor Mohamed E. A. Abdelrahim. When we contacted him after reading his list of publication he kindly provided his help and support.

Disclosure statement

No competing financial interests exist and no conflict of interest.

Authors contribution

Xiaoyu Liu: Planning, subject recruitment, data entry, writing. Wenhui Ju: Planning, subject recruitment, data entry, writing. Chuanhong Huo: Planning subject recruitment, data entry, writing. Shuhong Zhang: Planning subject recruitment, data entry, writing. Kai Huang: Concept, planning of study design, statistics, and writing.