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Modifiable Risk Factors for Hepatocellular Carcinoma in Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease: A Meta-Analysis - 24/10/24

Doi : 10.1016/j.amjmed.2024.06.031 
Shiyu Xiao, PhD a, Ya Liu, MM a, Xiliang Fu, MBBS b, Tong Chen, MBBS b, Wenhui Xie, PhD c,
a Department of Gastroenterology, Sichuan Provincial People's Hospital, Chengdu, China 
b School of Medicine, University of Electronic Science and Technology of China, Chengdu, China 
c Department of Rheumatology and Clinical Immunology, Peking University First Hospital, Beijing, China 

Requests for reprints should be addressed to: Wenhui Xie, PhD, Department of Rheumatology and Clinical Immunology, Peking University First Hospital, No.8, Xishiku Street, West District, Beijing 100034, China.Department of Rheumatology and Clinical ImmunologyPeking University First HospitalNo.8Xishiku StreetWest DistrictBeijing100034China

Abstract

Background and Aims

The increasing incidence of metabolic dysfunction-associated steatotic liver disease (MASLD) has led to a gradual increase in MASLD-related hepatocellular carcinomas (HCC). In this context, we aimed to investigate the association between modifiable factors and the risk of incident HCC in patients with MASLD.

Methods

Two authors independently searched electronic databases (PubMed, Embase, and the Cochrane Library) from their inception to April 1, 2023. Observational studies reporting an association between modifiable risk factors and MASLD-related HCC were eligible for inclusion. The effect size on the study outcomes was calculated using a random-effects model and was presented as a risk ratio with 95% confidence interval.

Results

A total of 31 studies covering 1.02 million individuals were included. Regarding lifestyle factors, smoking and alcohol consumption were associated with 30% (1.30 [1.08-1.57]) and 140% (2.41 [1.03-5.65]) risk increase of MASLD-related HCC. Regarding metabolic risk factors, patients with MASLD who were overweight or obese (1.31 [1.13-1.52]), had diabetes (2.08 [1.71-2.53]) and hypertension (1.42 [1.12-1.80]) had a higher risk of developing HCC, while dyslipidemia was negatively associated with MASLD-HCC (0.78 [0.65-0.93]). The use of metformin, statin, and aspirin was associated with 18% (0.82 [0.68-0.98]), 55% (0.45 [0.36-0.56]), and 36% (0.64 [0.44-0.92]) risk reduction in incident HCC, respectively.

Conclusions

This comprehensive systematic review and meta-analysis showed statistically significant increases in the risk of incident HCC inpatients with MASLD due to smoking, alcohol use, obesity, diabetes, and hypertension, whereas metformin, statin, and aspirin therapy might modify disease progression.

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Keywords : Hepatocellular carcinoma (HCC), Meta-analysis, Metabolic dysfunction-associated steatotic liver disease (MASLD), Modifiable risk factors, Systematic review


Plan


 Guarantor of the article: SYX and WHX has full responsibility for the conduct of the study.
 Funding: This work was supported by the Special Foundation for Young Scholars of Sichuan Provincial People's Hospital (2022QN62).
 Conflict of Interest: All authors have declared no conflicts of interest.
 Authorship: SYX and WHX conceived of the study participated in its design and coordination and critically revised the manuscript. SYX had full access to all the data collection, analysis, interpretation, and drafted the manuscript. SYX, YL, XLF, and TC contributed to the process of data collection and data analyses as a study investigator. All authors read and approved the final manuscript.


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Vol 137 - N° 11

P. 1072 - novembre 2024 Retour au numéro
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