New-Onset Age of Nonalcoholic Fatty Liver Disease and Cancer Risk

Abstract

ImportanceThe onset age of nonalcoholic fatty liver disease (NAFLD) is decreasing, and whether earlier ages of NAFLD onset are associated with increased cancer risk is currently unclear.ObjectiveTo explore the association between NAFLD new-onset age and cancer risk.Design, Setting, and ParticipantsThis cohort study was conducted among 179 328 participants included in the Kailuan Cohort Study between 2006 and 2021. In total, 46 100 incident NAFLD cases were identified. For each case, a participant matched by age (older or younger by 1 year) and sex was randomly selected to create a new matched study cohort. Data were analyzed from December 2022 through April 2023.ExposureOnset of NAFLD.Main Outcomes and MeasuresThe association between the onset age of NAFLD and the risk of different cancer types was evaluated using weighted Cox regression models. Population-attributable fractions (PAFs) were used to quantify the association of NAFLD with cancer risk at different ages.ResultsAmong 63 696 participants (mean [SD] age, 51.37 [12.43] years; ‭10 932 females [17.2%] and ‭52 764 males [82.8%]), 31 848 individuals had NAFLD and 31 848 individuals were in the control group. During a median (IQR) follow-up of 10.16 (7.89-11.67) years, 2415 patients were diagnosed with cancer. Compared with the matched group, patients aged less than 45 years at NAFLD onset exhibited a higher risk of cancer (average hazard ratio [AHR], 1.52; 95% CI, 1.09-2.12), and as the onset age of NAFLD increased, the cancer risk decreased (ages 45-54 years: AHR, 1.50; 95% CI, 1.15-1.97; ages 55-64 years: AHR, 1.13; 95% CI, 0.97-1.33; ages >65 years: AHR, 0.75; 95% CI, 0.45-1.27; P for interaction < .001). Among patients aged less than 45 years at NAFLD onset, cancers were mainly digestive system and lung cancers, with AHR values of 2.00 (95% CI, 1.08-3.47) and 2.14 (95% CI, 1.05-4.36), respectively. PAFs also showed that in patients aged less than 45 years at NAFLD onset, 17.83% (95% CI, 4.92%-29.86%) of cancer risk was attributable to NAFLD.‬‬‬‬Conclusions and RelevanceThis study found that NAFLD was associated with increased cancer risk and there was an interaction with onset age, such that the younger the onset age of NAFLD, the greater the cancer risk.

Systemic immune-inflammatory biomarkers (SII, NLR, PLR and LMR) linked to non-alcoholic fatty liver disease risk

“…The largest proportion of people were aged 40-59 years in our study. A cohort study showed that risk factors, prevalence, and characteristics of NAFLD patients varied by age group ( 42 ). Consider this about the fact that senescent cells cause age-related tissue degeneration and that the accumulation of senescent cells promotes hepatic fat accumulation and steatosis.…”

Association of glucagon-like peptide-1 receptor agonists with serious liver events among patients with type 2 diabetes: A Scandinavian cohort study

“…Notably, studies using the same Scandinavian public health data resources as those used in this study have quantified a significant disease burden in this younger age group that is associated with an increased long-term mortality risk 8 . A recently published prospective cohort study of 35,860 Chinese patients also suggested that an earlier onset of MASLD was linked with a higher risk of liver cancer with an adjusted HR of 2.66 for those under the age of 45 9 . The exclusion of this patient group from the analysis has the potential to affect both the primary and secondary outcome measures and the conclusions drawn therein.‬…”

The association of metabolic syndrome score trajectory patterns with risk of all cancer types

“…This involved using the significance levels of the cubic, quadratic, and linear terms to determine the most appropriate functional form for each trajectory pattern. 10,13,14 Inflammation and MetS may interact in a synergistic manner to increase the risk of cancer. 15 To further investigate this association, we conducted a subgroup analysis by categorizing participants based on their CRP levels.…”