Association between nonalcoholic fatty liver disease and extrahepatic cancers: a systematic review and meta-analysis

Liu, Shousheng; Ma, Xuefeng; Zhao, Jie; Du, Shiwei; Zhang, Jie; Dong, Mingjie; Xin, Yongning

doi:10.21203/rs.3.rs-16707/v2

Cited by 9 publications

(16 citation statements)

References 44 publications

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Section: Discussionmentioning

confidence: 99%

“…In a meta‐analysis, Liu et al investigated the association between NAFLD and the risk of cholangiocarcinoma, colon, breast, gastric, pancreatic, prostate and oesophageal cancer 32 . In logistic regression, NAFLD was associated with colorectal (odds ratio [OR] 1.72 [ p < .01]), gastric (OR 1.74 [ p = .01]) and prostate cancer (OR 1.36 [ p < .01]) 32 . The heterogeneity between the studies investigating colorectal, gastric and prostate cancers was significant ( I 2 83.5% for colorectal, 73.6% for gastric and 81.9% for prostate cancer).…”

Section: Discussionmentioning

confidence: 99%

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Risk of hepatic and extrahepatic cancer in NAFLD: A population‐based cohort study

Björkström

Widman

Hagström

2022

Liver International

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Background and Aims Individuals with non‐alcoholic fatty liver disease (NAFLD) may be at greater risk of cancer. This study aimed to investigate the risk of hepatic and extrahepatic cancer compared to the general population in a population‐based cohort of patients with NAFLD. Methods We used the Swedish National Patient Registry from 1987 to 2016 to identify patients with a NAFLD diagnosis and no prior cancer. All patients with NAFLD were compared to up to 10 controls matched for age, sex and living location. The primary outcome was the first occurrence of any cancer as ascertained from national registries. As secondary outcomes, we analysed the risk of pre‐specified cancer subtypes. Cox regression models, adjusted for baseline diabetes, hypertension, hyperlipidaemia and chronic obstructive pulmonary disease were applied. Results We identified 8415 patients with NAFLD. Over a median follow‐up of 6.0 years (IQR 2.5–11.2 years), an increased risk for any cancer was found in patients with NAFLD compared to controls (9.7 vs. 8.6 cases per 1000 person‐years): hazard ratio (HR) = 1.22 (95% confidence interval, CI = 1.12–1.33). The risk for hepatocellular carcinoma (HCC) was particularly high (adjusted HR, aHR = 12.18, 95% CI = 7.15–20.79). The risk for some other cancer subtypes increased (colorectal [aHR 1.38], kidney [aHR 2.12], bladder [aHR 2.51] and uterine [aHR 1.78]), but was low in absolute terms. Conclusion In this population‐based cohort, NAFLD was associated with an increased risk of developing cancer (especially HCC). The absolute risk for other forms of cancer was generally comparable to the control population.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Risk of hepatic and extrahepatic cancer in NAFLD: A population‐based cohort study

Björkström

Widman

Hagström

2022

Liver International

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“…From their analysis, they determined that the odds of developing CRC in patients with NAFLD were almost doubled, while the odds for developing intrahepatic cholangiocarcinoma and extrahepatic cholangiocarcinoma in patients with NAFLD were increased 2.5 times compared to those without NAFLD. The odds of developing breast cancer gastric cancer, pancreatic cancer, prostate cancer and oesophageal cancer were also found to be significantly increased 149 . However, another study from Sweden found that the presence of NAFLD was only modestly associated with increased rates of pancreatic cancer, kidney/bladder cancer and melanoma but no other cancers 150 .…”

Section: Extra Hepatic Cancer and Nafld Mortalitymentioning

confidence: 95%

Review article: the epidemiologic burden of non‐alcoholic fatty liver disease across the world

Henry

Paik

Younossi

2022

Aliment Pharmacol Ther

116

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Summary Background The prevalence of non‐alcoholic fatty liver disease (NAFLD) is increasing in parallel with obesity and type 2 diabetes. Aim To review the global epidemiology of NAFLD Methods We retrieved articles from PubMed using search terms of NAFLD, epidemiology, prevalence, incidence, and comorbidities. Results Over 250 articles were reviewed. In 2016, the global NAFLD prevalence was 25%; this increased to >30% in 2019. Prevalence in Asia, Latin America and Middle East‐North Africa (MENA) was 30.8%, 34.5% and 42.6%, respectively. Prevalence increased with age. Although prevalence was higher in men, prevalence in post‐menopausal women was similar. NAFLD prevalence was higher in certain subpopulations, especially among the obese and those with metabolic syndrome (MS). However, the prevalence of lean NAFLD was 11.2%. The global prevalence of non‐alcoholic steatohepatitis (NASH) is estimated between 2% and 6% in the general population. Approximately 7% of patients with NAFLD have advanced fibrosis; rates were between 21% and 50% among patients with NASH. Overall mortality related to NAFLD was 15–20 per 1000 person‐years, and increased substantially in patients with NASH, especially in those with components of MS. Recent data suggest mortality/morbidity from NAFLD is increasing globally but NAFLD awareness remains low among patients and healthcare providers. Conclusions NAFLD poses a global public health problem with a very high disease burden in Asia, MENA and Latin America. Research is needed to better quantify the full impact of NAFLD and to develop strategies to improve awareness and risk stratification.

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“…NAFLD not only contributes to the development of liver cirrhosis and cardiovascular complications but also acts as an etiological factor for cancer initiation and progression. A systemic review and meta-analysis concluded that NAFLD may trigger hepatocellular, colorectal, breast, pancreatic, prostate, and esophageal cancer [ 23 , 24 ]. Though the exact mechanism underlying NAFLD-induced cancer is not well-established, the possible contributing factors may include unregulated efflux of adipokines, increased levels of IGF-1, insulin, and cytokines (TNF- α , IL-6), accelerated hepatocyte proliferation, lipid peroxidation, oxidative stress, DNA damage, and lipotoxicity [ 25 – 29 ].…”

Section: Pathophysiology Of Hepatic Disorders and Dmmentioning

confidence: 99%

Reenvisioning Traditional to Regenerative Therapeutic Advances in Managing Nonalcoholic Fatty Liver Disease in Diabetes Mellitus

Tsai

Dubey

et al. 2021

Journal of Diabetes Research

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Reports indicate the increasing prevalence of liver disorders in diabetes mellitus (DM) patients. Clinically, it has also been revealed that the existence of nonalcoholic fatty liver disease (NAFLD) enhances the incidence of type 2 diabetes mellitus (T2DM), while T2DM exacerbates NAFLD to extremely severe forms of steatohepatitis, cirrhosis, and hepatocellular carcinoma. This implies the coexistence and bidirectional nature of NAFLD and T2DM, which function synergistically to drive adverse consequences in clinical practice. For treatment of such comorbid state, though the existing practices such as lifestyle management, traditional Chinese medicines (TCM), and pharmaceuticals have offered somewhat relief, the debate continues about the optimal therapeutic impacts. Recent developments in the field of tissue engineering have led to a renewed interest in novel biomaterial alternatives such as stem cells. This might be attributable to their differentiation potential towards hepatic and pancreatic lineage. These cellular therapies could be further complemented by platelet-derived biomaterials, TCM formulations, or any specific drug. Based on these abovementioned approaches, we aimed to comprehensively analyze various preclinical and clinical studies from traditional to regenerative therapeutic approaches in managing concomitant NAFLD and T2DM.

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Association between nonalcoholic fatty liver disease and extrahepatic cancers: a systematic review and meta-analysis

Cited by 9 publications

References 44 publications

Risk of hepatic and extrahepatic cancer in NAFLD: A population‐based cohort study

Risk of hepatic and extrahepatic cancer in NAFLD: A population‐based cohort study

Review article: the epidemiologic burden of non‐alcoholic fatty liver disease across the world

Reenvisioning Traditional to Regenerative Therapeutic Advances in Managing Nonalcoholic Fatty Liver Disease in Diabetes Mellitus

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