In order to explore multiple risk factors of hepatocellular carcinoma (HCC), a total of 13 737 male adult residents in 12 townships were studied for an average follow‐up period of 5.2 years. Sociodemographic characteristics, history of cigarette smoking and alcohol drinking, dietary habits, as well as personal and familial history of chronic liver diseases were obtained through standardized interviews based on structured questionnaires at the recruitment. Blood samples were also collected from 9688 (71%) study subjects and examined for the hepatitis B surface antigen (HBsAg). A total of 60 new HCC cases occurred giving an incidence rate of 83.3 per 100 000 person‐years. Cox's proportional hazards models were used to analyse multiple risk factors of HCC. In addition the HBsAg carrier status which showed a multivariate‐adjusted relative risk of 17.0, cumulative cigarette smoking, alcohol drinking quantity, vegetarian habit and low vegetable consumption were associated with the development of HCC. The multivariate‐adjusted relative risk was 1.8 for those who smoked 26 or more pack‐years of cigarettes compared with non‐smokers, 3.1 for those who drank alcohol 50 mL or more per day compared with those who were non‐drinkers or drank less than 50 mL per day, 2.5 for vegetarians compared with non‐vegetarians, as well as 4.6 and 2.6, respectively, for those who had a weekly vegetable consumption frequency of less than two meals and two to five meals compared with those who had a frequency of six or more meals.
A community health survey of 923 residents aged 30 years or more was performed in Putai Township of Taiwan. To elucidate the relationships between hepatitis C virus (HCV) and surrogate tests for non-A, non-B hepatitis in hyperendemic areas of hepatitis B virus (HBV) serum levels of alanine aminotransferase (ALT), triglycerides, cholesterol, hepatitis B surface antigen (HBsAg) and antibody to HCV (anti-HCV) were examined. Glucose tolerance tests and the history of diabetes treatment were used to define the diabetes status. Fatty liver was diagnosed by sonography. The prevalence of anti-HCV was 2.6% (95% confidence interval, 1.6-3.6%). Elevated ALT and fatty liver were significantly associated with anti-HCV in univariate analysis. Anti-HCV was not an associated factor for fatty liver after adjusting for serum triglycerides and cholesterol, sex, body mass index and diabetes status through multiple logistic regression. However elevated ALT was still associated with anti-HCV after adjusting for serum triglycerides, sex, body mass index, HBsAg and age through multiple linear regression. The anti-HCV prevalence was similar between HBsAg-positive and negative subjects. Aggregation of HCV infection was found among spouses. It was concluded that elevated ALT and intimate contact with HCV carriers might be associated factors for HCV infection, and that HBV infection and fatty liver were not related to HCV infection in Taiwan.
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