A 14-year prospective study of 2,260 Taiwanese men from the REVEAL-HBV cohort investigated the combined effects of body mass index (BMI) and alcohol use on hepatocellular carcinoma (HCC) risk. Participants, all hepatitis B surface antigen-positive, had a mean age of 46 years, an average BMI of 24 kg/m², and 20% reported alcohol use. The study identified a significant interaction between BMI and alcohol in predicting incident HCC (P = .029). Notably, extreme obesity (BMI ≥30 kg/m²) and alcohol use showed a synergistic effect, significantly increasing HCC risk in multivariable-adjusted analyses (HR, 3.40; 95% CI, 1.24–9.34; P < .025). Stratified analyses revealed higher HCC risk in alcohol users who were overweight (HR, 2.4), obese (HR, 2.0), or extremely obese (HR, 2.9), indicating a trend of increasing risk with rising BMI (P for trend = .046).
The study highlights a multiplicative interaction between alcohol use and extreme obesity, with relative risk and synergy index measures confirming the combined impact on HCC risk. These findings underscore the importance of lifestyle interventions targeting alcohol consumption and weight management to reduce HCC incidence, particularly in hepatitis B-positive populations.
Reference: Loomba R, Yang HI, Su J, et al. Obesity and alcohol synergize to increase the risk of incident hepatocellular carcinoma in men. Clin Gastroenterol Hepatol. 2010 Oct;8(10):891-8, 898.e1-2. doi: 10.1016/j.cgh.2010.06.027. Epub 2010 Aug 17. PMID: 20621202.
