Effect of chronic viral hepatitis and metabolic factors on renal cancer risk in a large cohort in Republic of Korea

초록

Purpose: We investigated the association between hepatic and metabolic factors and renal cancer risk.Methods: This population-based cohort study included cancer-free individuals who underwent general health evaluation (January to December 2010) at the Korean National Health Insurance Service and followed-up through 2017. Hazard ratios (HR) and 95% confidence intervals (CI), determined by adjusted Cox regression analysis were used to investigate the effect of variables on renal cancer risk.Results: Among 4,518,704 subjects, 6531 patients developed renal cancer. Adjusted analyses of epidemiological factors and BMI (body mass index) (Model I) showed serum high-density lipoprotein cholesterol (HDL-C) >= 60 mg/dL (adjusted HR [aHR] 0.88, 95% CI, 0.81-0.95) reduced renal cancer risk comparing to low HDL-C, whereas hepatitis B virus (HBV) antigen (aHR 1.41, 95% CI 1.19-1.68) and chronic HBV infection (aHR 1.65, 95% CI 1.26-2.17) increased its risk. Higher BMI increased renal cancer risk in dose-dependent manner (P for trend <0.001). This association persisted after adjustment for epidemiological factors and waist circumference (Model II). Sex-specific analyses showed similar effect of HBV antigen and chronic HBV infection in both sexes. Normal (50-59 mg/dL in women) or high (>= 60 mg/dL in men) HDL-C reduced renal cancer risk. Alcohol consumption increased kidney cancer risk in age >= 60 years, but it had no association with renal cancer in age < 60 years.Conclusions: High serum HDL-C levels reduced and HBV antigen and chronic HBV infection increased renal cancer risk across different adjusted analysis models. This effect of low HDL-C and chronic HBV infection per-sisted in sex-based subanalysis.

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