Management of stage Ⅳ rectal cancer - World Journal of ...

A
Age (yr)
90
80
70
60
50
40
P < 0.05
NS P < 0.05 NS
as the core protein, cause oxidative damage by exposing
the endoplasmic reticulum to oxidative stress [19-21] . Hepatic
oxidative stress is strongly associated with increased risk
for HCC in patients with chronic HCV [22] . Because oxidative
stress is also caused by various host-related factors, it
is expected to be influenced more strongly by host-related
factors in HCV-infected patients than in those with HCVnegative
liver disease. Indeed, we have previously reported
that visceral fat accumulation was associated with greater
insulin resistance in chronic HCV patients than in those
with non-alcoholic fatty liver disease [23] . Therefore, it is
plausible that the association between earlier onset of
HCC and increased BMI is due to the generation of hepatic
oxidative stress.
An interesting aspect of our results is that underweight
patients, defined as those with a BMI of < 18.5 kg/m 2 ,
tended to be older at HCC onset than patients within the
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P < 0.05
NS
< 18.5 18.5-25 25-30 30 <
BMI
Figure 3 Differences in age at onset of hepatocellular carcinoma stratified by body mass index according to sex (A: Men; B: Women). Statistical analysis
was performed using the Tukey-Kramer method. NS: Not significant; BMI: Body mass index.
A
Age (yr)
90
80
70
60
50
40
P < 0.05
P < 0.05
< 18.5 18.5-25 25-30 30 <
BMI
NS
P < 0.05 P < 0.05 NS
B
Age (yr)
90
80
70
60
50
40
NS
NS NS NS
< 18.5 18.5-25 25-30 30 <
Figure 4 Differences in age at onset of hepatocellular carcinoma stratified by body mass index according to degree of alcohol consumption (A: Non-heavy
drinkers < 60 g/d; B: Heavy drinkers ≥ 60 g/d). Statistical analysis was performed using the Tukey-Kramer method. NS: Not significant; BMI: Body mass index.
B
Age (yr)
90
80
70
60
50
40
Akiyama T et al . BMI and age at HCC onset
NS
normal weight range (BMI 18.5-25 kg/m 2 ). Recently, Ohki
et al [11] reported that patients with a BMI < 18.5 kg/m 2
had the lowest risk of developing HCC due to chronic
HCV infection among all BMI groups. In general, the
mortality rate associated with cardiovascular disease or
cancer is higher in underweight patients than in normal
weight patients [24,25] . Clearly, a larger cohort study is needed
to investigate whether leanness confers a protective effect
against hepatocarcinogenesis in HCV-infected patients.
Excessive alcohol consumption is also known to exacerbate
hepatic oxidative stress and evoke liver fibrosis
or HCC [20,26] . In this study, there was no association between
BMI and age at onset of HCC in heavy drinkers.
We speculate that this group may include some patients
who are malnourished and possibly losing weight.
Sex modulates the natural history of chronic liver disease.
Previous studies have suggested that chronic HCV
919 February 21, 2011|Volume 17|Issue 7|
NS
BMI
NS
NS
NS NS NS
< 18.5 18.5-25 25-30 30 <
BMI
NS