Indian Journal of Gastroenterology

, Volume 38, Issue 1, pp 61–68 | Cite as

Association between metabolic syndrome and hepatobiliary cancers: A case-control study

  • Shyam MenonEmail author
  • Ray Mathew
Original Article



The incidence of hepatobiliary cancer is steadily increasing. It is unclear if this rise is related to increasing trends in obesity, metabolic syndrome, and lifestyle changes.


A case-control study was performed using the Health Improvement Network (THIN) database. Cases with a diagnosis of liver, bile duct, and gallbladder cancers were matched in a 1:2 fashion with controls and analyzed for potential associations between hepatobiliary cancer and obesity/metabolic syndrome.


Four thousand two hundred and eighty-seven patients (62% male, 38% female) with hepatobiliary cancers were matched with 8574 controls. On univariate analysis, body mass index (BMI), smoking, diabetes, alcohol consumption, ischemic heart disease, and hypertension were associated with hepatobiliary cancer. Statin use and non-smoking status had an inverse association. On multivariate analysis, BMI, diabetes, hypertension, ischemic heart disease, and insulin use were associated with the risk of hepatobiliary cancer. Statin use and non-smoking status were protective. On modeling BMI, each of diabetes and hypertension as a single covariate, there was a significant association with hepatobiliary cancer (1.59 [1.49–1.69], p < 0.001) which persisted despite adjusting for increasing age (1.006 [1005–1.006], p < 0.001) and background liver cirrhosis (1.037 [1.03–1.044], p < 0.001).


Obesity and metabolic syndrome are associated with the risk of hepatobiliary cancer. Statin use seems to be protective.


Hepatobiliary cancer Hepatocellular cancer Cholangiocarcinoma Metabolic syndrome Diabetes Obesity 




Funding details

This research was funded by a grant from the South Staffordshire Medical Centre Charitable Trust (The Rotha Abraham Bequest).

Compliance with ethical standards

Conflict of interest

SM, and RM declare that they have no conflict of interest.

Ethical clearance

The authors declare that the study was performed in a manner conforming to the Helsinki declaration of 1975, as revised in 2000 and 2008 concerning human and animal rights, and the authors followed the policy concerning informed consent as shown on


The authors are solely responsible for the data and the content of the paper. In no way, the Honorary Editor-in-Chief, Editorial Board Members, or the printer/publishers are responsible for the results/ findings and content of this article.

Supplementary material

12664_2018_925_MOESM1_ESM.docx (13 kb)
ESM 1 (DOCX 13 kb)


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Copyright information

© Indian Society of Gastroenterology 2019

Authors and Affiliations

  1. 1.The Royal Wolverhampton NHS TrustWolverhamptonUK

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