Effect of Statin Use on Liver Cancer Mortality Considering Hypercholesterolemia and Obesity in Patients with Non-Cirrhotic Chronic Hepatitis B.
Gi Ae KimJae-Jun ShimJi Sung LeeByung-Ho KimJung Wook KimChi Hyuk OhChang-Mo OhIn-Hwan OhSo Youn ParkPublished in: Yonsei medical journal (2020)
Little is known about the benefits of statin use on liver cancer mortality among patients with chronic hepatitis B (CHB) considering hypercholesterolemia and obesity. A nationwide retrospective cohort study was conducted using data from a Health Examination Cohort of the National Health Insurance Service of Korea. Data on CHB patients with no other concurrent liver disease were acquired, and statin use was defined as a cumulative daily dose ≥28. A 3-year landmark analysis was performed to avoid immortal time bias. Patients who started statin therapy within the landmark date were considered statin users. A Cox regression analysis was applied to assess associations between statin use and liver cancer mortality considering hypercholesterolemia and obesity. Among 13063 patients, 193 (1.5%) died of liver cancer during the mean follow-up period of 10.6 years. After adjusting for demographic and metabolic factors, statin use [hazard ratio (HR), 0.17; 95% confidence interval (CI), 0.04-0.70] and hypercholesterolemia (HR, 0.46; 95% CI, 0.24-0.88 for total cholesterol ≥240 mg/dL) were associated with a decreased risk of liver cancer mortality, whereas body mass index (BMI) ≥30 kg/m² was associated with an increased risk of liver cancer mortality (HR, 2.46; 95% CI, 1.20-5.06). This study showed that statin use was associated with decreased liver cancer mortality when adjusting for cholesterol levels and BMI. This study found that hypercholesterolemia was independently associated with decreased liver cancer mortality regardless of statin use.
Keyphrases
- low density lipoprotein
- cardiovascular events
- coronary artery disease
- cardiovascular disease
- body mass index
- weight gain
- health insurance
- type diabetes
- healthcare
- risk factors
- insulin resistance
- weight loss
- squamous cell carcinoma
- physical activity
- hepatitis b virus
- mental health
- public health
- stem cells
- electronic health record
- big data
- climate change
- high fat diet induced
- social media
- data analysis
- cross sectional