Impact of diabetes, obesity, and dyslipidemia on the risk of HCC in patients with chronic liver diseases

Clin Mol Hepatol. 2022 Aug 8. doi: 10.3350/cmh.2021.0383. Online ahead of print.ABSTRACTDespite the increasing prevalence of metabolic disorders, the potential effects of metabolic factors on hepatocellular carcinoma (HCC) development in individuals with chronic liver diseases (CLDs) are not well understood. For a metabolic factor to be identified as a risk factor for HCC in patients with CLDs, such as hepatitis B virus (HBV) and hepatitis C virus (HCV) infection, there should be a strong synergistic interaction between the carcinogenic mechanisms of the metabolic factor and the CLD itself. This review aims to comprehensively summarize the published data on the relationship between metabolic factors such as diabetes mellitus (DM), obesity, and blood lipids and the risk of HCC in patients with CLDs. DM consistently increases the risk of HCC in patients with CLD. When associated with DM, the risk of HCC seems to be highest in HCV and non-alcoholic fatty liver disease (NAFLD), followed by alcoholic liver disease (ALD) and HBV. However, HCV and NAFLD increase the incidence of DM, and comorbid DM can be a marker of CLD severity. Therefore, at least part of the effects of DM reflects reverse causality. Obesity may increase the risk of HCC; however, the magnitude of effects seems to be modest in patients with CLDs compared to that in the general population. Among CLDs, the evidence is relatively consistent and clear for ALD, while clear evidence is limited in other CLDs including HB...
Source: Clinical and molecular hepatology - Category: Gastroenterology Authors: Source Type: research