Prolonged infection with hepatitis B virus and association between low blood cholesterol concentration and liver cancer.

Z Chen; A Keech; R Collins; B Slavin; J Chen; T C Campbell; R Peto

doi:10.1136/bmj.306.6882.890

journal article Apr 03, 1993

Prolonged infection with hepatitis B virus and association between low blood cholesterol concentration and liver cancer.

Z Chen A Keech R Collins B Slavin J Chen T C Campbell R Peto

BMJ Vol. 306 No. 6882 pp. 890-894 · BMJ

View at Publisher Save 10.1136/bmj.306.6882.890

Abstract

OBJECTIVE--To determine whether prolonged infection with hepatitis B virus is associated with a lower blood cholesterol concentration. DESIGN--Cross sectional study. SETTING--81 villages in rural China with a high prevalence of chronic infection with hepatitis B virus. SUBJECTS--1556 apparently healthy men aged 35-64 years, randomly selected. MAIN OUTCOME MEASURES--Hepatitis B virus carrier state; plasma concentrations of cholesterol, apolipoprotein B, and apolipoprotein A I. RESULTS--238 (15%) of the men were positive for hepatitis B surface antigen, indicating that they were chronic carriers. Plasma concentration of cholesterol was 4.2% (0.11 mmol/l) lower among carriers (that is, positive for hepatitis B surface antigen) than among non-carriers (95% confidence interval 0.6% to 8.0% (0.01 to 0.21 mmol/l), p < 0.05), and apolipoprotein B concentration was 7.0% (0.036 g/l) lower (2.8% to 11.2% (0.014 to 0.058 g/l), p < 0.001). In contrast, no association was observed between plasma concentrations of cholesterol or apolipoprotein and hepatitis B that had been eradicated (that is, patient positive for hepatitis B core antibody but negative for hepatitis B surface antigen). CONCLUSIONS--Chronic hepatitis B virus infection, which usually starts in early childhood in China, seems to lead not only to a greatly increased risk of death from liver disease but also to a somewhat lower cholesterol concentration in adulthood. This common cause produces an inverse association between cholesterol concentration and risk of death from liver cancer or from other chronic liver diseases.

Topics

No keywords indexed for this article. Browse by subject →

References

35

[1]

Rose G, Blackburn H, Keys A, Taylor HL, Kannel WB, Paul 0, et al. Colon cancer and blood cholesterol. Lancet 1974;i: 181-3.

[2]

Rose G, Shipley MJ. Plasma lipids and mortality: a source of error. Lancet 1980;i:523-6. 10.1016/s0140-6736(80)92775-0

[3]

International Collaborative Group. Circulating cholesterol level and risk of death from cancer in men aged 40-69 years. Experience of an intemational collaborative group. jAMA 1982;248:2853-9.

[4]

Sherwin RW, Wentworth DN, Cutler JA, Hulley SB, Kuller LH, Stamler J. Serum cholesterol levels and cancer mortality in 361662 men screened for the multiple risk factor intervention trial. JAMA 1987;257:943-8. 10.1001/jama.1987.03390070063024

[5]

Knekt P, Reunanen A, Aromaa A, Heliovaara M, Hakulinen T, Hakama M. Serum cholesterol and risk of cancer in a cohort of 39,000 men and women. JClin Epidemiol 1988;41:519-30. 10.1016/0895-4356(88)90056-x

[6]

Kagan A, McGee DL, Yano K, Rhoads GG, Nomura A. Serum cholesterol and mortality in a Japanese-American population. Am J Epidemiol 1981; 114:11-20. 10.1093/oxfordjournals.aje.a113157

[7]

Williams RR, Sorlie PD, Feinleib M. Cancer incidence by levels of cholesterol. jAMA 1981;245:247-52. 10.1001/jama.1981.03310280023021

[8]

Beaglehole R, Foulkes MA, Prior IA, Eyles EF. Cholesterol and mortality in New Zealand Maoris. BMJ 1980;280:285-7. 10.1136/bmj.280.6210.285

[9]

Schatzkin A, Hoover RN, Taylor RR, Ziegler R, Carter CL, Larson DB, et al. Serum cholesterol and cancer in the NHANES I epidemiologic follow-up study. Lancet 1987;ii:298-301.

[10]

Isles CG, Hole DJ, Gillis CR, Hawthome VW, Lever AF. Plasma cholesterol, coronary heart disease, and cancer in the Renfrew and Paisley survey. BMJ 1989;298:920-4. 10.1136/bmj.298.6678.920

[11]

Smith GD, Shipley M, Marmot MG, Rose G. Plasma cholesterol concentration and mortality-the Whitehall study. JAMA 1992;267:70-6. 10.1001/jama.1992.03480010078028

[12]

Chen ZM, Peto R, Collins R, MacMahon S, Lu JR, U WX. Serum cholesterol concentration and coronary heart disease in population with low cholesterol concentrations. BMJ 1991;303:276-82. 10.1136/bmj.303.6797.276

[13]

Salonen JT. Risk of cancer and death in relation to serum cholesterol: a longitudinal study in an eastem Finnish population with high overall cholesterol level. AmJEpidemiol 1982;116:622-30.

[14]

Dyer AR, Stamler J, Paul 0. Serum cholesterol and risk of death from cancer and other causes in three Chicago epidemiological studies. Journal ofChronic Disease 1981;34:249-60. 10.1016/0021-9681(81)90030-8

[15]

Jacobs D, Blackbum H, Higgins M, Reed D, Iso H, McMillan G, et al. Report of the conference on low blood cholesterol: mortality associations. Circulation 1992;86:1046-60. 10.1161/01.cir.86.3.1046

[16]

Neaton JD, Blackbum H, Jacobs D, Kuller L, Lee DJ, Sherwin R, et al. Serum cholesterol level and mortality: findings for men screened in the multiple risk factor intervention trial. Arch Intern Med 1992;152:1490-500. BMJ VOLUME 306 3 APIRL 1993 10.1001/archinte.1992.00400190110021

[17]

Jiang YT. Epidemiological studies of viral hepatitis A and B in the People's Republic of China. In: Szmuness W, Alter HJ, Maynard JE, eds. Viral hepatitis. Philadelphia: Franklin Institute Press, 1982:121-8.

[18]

Beasley RP, Lin CC, Hwang LY, Chien CS. Hepatocellular carcinome and hepatitis B virus. A prospective study of 22707 men in Taiwan. Lancet 1981;ii:1 129-32.

[19]

Chen JS, Campbell TC, Li JY, Peto R. Diet, lifestyle and mortality in China: a study of the characteristics of 65 Chinese counties. Oxford: Oxford University Press, 1990.

[20]

Li JY, Liu BQ, U GY, Chen ZJ, Sun XD, Rong SD. Atlas of cancer mortality in the People's Republic of China. An aid for cancer control and research. IntJEpidemiol 1981;10:127-33.

[21]

Forman D, Sitas F, Newell DG, Stacey AR, Boreham J, Peto R, et al. Geographic association of Helicobacter pylori antibody prevalence and gastric cancer mortality in rural China. IntJ Cancer 1990;46:608-1 1. 10.1002/ijc.2910460410

[22]

Ma XK. Synthesis of HBsAg and its application in diagnosis of viral hepatitis B. China People's LiberationArmy Medicalyournal 1984;9:1-5.

[23]

Enzyme-linked immunosorbent assay (ELISA) quantitative assay of immunoglobulin G

Eva Engvall, Peter Perlmann

Immunochemistry 1971 10.1016/0019-2791(71)90454-x

[24]

Mount JH, Kearney EM, Rossenen M, Slavin BM. Immunoturbidimetric assays for serum apolipoproteins Al and B using cobas bio centrifugal analysis.JClin Pathol 1988;41:471-4. 10.1136/jcp.41.4.471

[25]

Lumb PJ, Slavin BM. Determination of serum cholesterol concentration in the presence of ascorbate. J Clin Pathel (in press).

[26]

Cox DR, Hinkley DV. Distribution-free and randomisation tests. In: Thoretical statistics. London: Chapman and Hall, 1974.

[27]

McQuillan GM, Townsend TR, Fields HA, Carroll M, Leahy M, Polk BF. Seroepidemiology of hepatitis B virus infection in the United States: 1976-1980. AmJMed 1989;87(suppl 3A):55-105.

[28]

Meade TW, Stirling Y, Thompson SG, Ajdukiewicz A, Barbara JAJ, Chalmers DM. Carriers of hepatitis B surface antigen: possible association between low levels of clotting factors and protection against ischaemic heart disease. Thromb Res 1987;45:709-13. 10.1016/0049-3848(87)90336-7

[29]

Stevens CE, Beasley RP, Tsui J, Lee WC. Vertical transmission of hepatitis B antigen in Taiwan. NEnglJMed 1975;292:771-4. 10.1056/nejm197504102921503

[30]

Beasley RP, Trepo C, Stevens CE, Szmuness W. The e antigen and vertical transmission of hepatitis B surface antigen. AmJ Epidemiol 1977;105:94-8. 10.1093/oxfordjournals.aje.a112370

[31]

Okada K, Kamiyama I, Inomata M, Imai M, Miyakawa Y, Mayumi M. e Antigen and anti-e in the serum of asymptomatic carrier mothers as indicators of positive and negative transmission of hepatitis B virus to their infants. NEnglJMed 1976;294:746-9. 10.1056/nejm197604012941402

[32]

McMahon BJ, Alward WLM, Hall DB, Heyward WI, Bender TR, Francis D, et al. Acute hepatitis B virus infection: relation of age to the clinical expression of disease and subsequent development of the carrier state. IlnfectDis 1985;151:599-603. 10.1093/infdis/151.4.599

[33]

Feely J, Barry M, Keeling PWN, Weir DG, Cooke T. Upoprotein(a) in cirrhosis. BMJ 1992;304:545-6. 10.1136/bmj.304.6826.545

[34]

Piantadosi S, Byar DP, Green SB. The ecological fallacy. Am Jf Epidemiol 1988;127:893-904. 10.1093/oxfordjournals.aje.a114892

[35]

Ueyama Y, Matsuzawa Y, Yamashita S, Funahashi T, Sakai N, Nakamura T, et al. Hypocholesterolaemic factor from gallbladder cancer cells. Lancet 1990;336:707-9. 10.1016/0140-6736(90)92204-u

Metrics

33

Citations

35

References

Details

Published: Apr 03, 1993
Vol/Issue: 306(6882)
Pages: 890-894
License: View

Authors

Cite This Article

Z Chen, A Keech, R Collins, et al. (1993). Prolonged infection with hepatitis B virus and association between low blood cholesterol concentration and liver cancer.. BMJ, 306(6882), 890-894. https://doi.org/10.1136/bmj.306.6882.890

Prolonged infection with hepatitis B virus and association between low blood cholesterol concentration and liver cancer.

You May Also Like