Perceived dietary salt intake and the risk of primary liver cancer: a population‐based prospective study

Abstract

Background Although a high‐salt diet is associated with high risk of chronic diseases such as hypertension, stroke and cardiovascular disease, little is known about the relationship between a high‐salt diet and the risk of primary liver cancer (PLC). Consequently, we prospectively assessed the association of high perceived salt intake with the risk of PLC in the Kailuan Study. Methods In total, 97 006 participants who were healthy adults or free living adults at the baseline (2006) were included in the present study. The data of perceived salt intake were collected via questionnaire and classified into three categories: <6 g day−1 for low salt intake, 6–10 g day−1 for intermediate salt intake, >10 g day−1 for high‐salt intake. PLC including hepatocellular carcinoma and intrahepatic cholangiocarcinoma (excluding liver metastasis), and was confirmed by review of medical records. We used a Cox proportional hazards model to analyse the association between high perceived salt diet and the risk of PLC after adjusting for possible confounders, including age, gender, body mass index, high sensitivity‐C‐reactive protein, low‐density lipoprotein‐cholesterol, total cholesterol, triglycerides, alanine aminotransferase, HbsAg positive, cirrhosis, fatty liver, hypertension, diabetes, drinking status, smoking status and physical exercise. Results During the follow‐up period of 1 113 816 person‐years, 397 PLC events were diagnosed. After adjusting for most potential confounders, subjects in intermediate salt intake and high salt intake had a multivariable hazard ratio and 95% confidence interval of 1.49 (0.97–2.29) and 1.98 (1.22–3.22) (P for trend = 0.0042), respectively, compared to low salt intake. Conclusions A higher perceived salt intake was associated with a higher risk of PLC.

Dietary salt in liver cirrhosis: With a pinch of salt!

“…According to this viewpoint, the dietary salt recommendation for advanced cirrhosis patients is similar to that of the normal healthy population. In a population-based study, subjects with intermediate salt intake (6–10 g/d) and high salt intake (> 10 g/d) were found to have a higher risk of hepatocellular carcinoma with a multivariable hazard ratio (HR) of 1.49 and 1.9, respectively, compared to those with low salt intake (< 6 g/d)[ 37 ]. A recent cohort study from Iran reported that high dietary intake of salt (9.5–15 g/d) increases the rate of mortality in patients with cirrhosis (HR 2.26).…”

Hepatocellular Carcinoma and Obesity, Type 2 Diabetes Mellitus, Cardiovascular Disease: Causing Factors, Molecular Links, and Treatment Options

“…One study showed that consumption of caffeinated coffee with an extra two cups daily was positively associated with reduction in the risk of HCC, which was also shown with consumption of decaffeinated coffee to some extent ( 106 ). Another study showed that intermediate-salt (6-10 g/day) or high-salt (>10 g/day) intake displayed a higher risk to develop primary liver cancer compared to low-salt intake (<6 g/day), after adjusting other potential cofactors such as fatty liver, hypertension, and diabetes ( 107 ). Lifestyle intervention can effectively result in low body fat mass, reduction of visceral adiposity, and a decrease of metabolic diseases, including NAFLD, CVD, and T2DM ( 108 , 109 ); therefore, change of lifestyle plays an essential role in preventing HCC development.…”

High salt intake combined with hypertension elevated the risk of primary liver cancer: a prospective cohort study

“…Recently, studies proved a positive association between arterial hypertension and the development of several types of cancers including PLC (6)(7)(8). It is worth noting that high salt intake, a causal factor of hypertension, has also been proven to be closely related to the occurrence of several types of cancer (9)(10)(11). China is a fastgrowing and rapidly-aging nation with approximately 200 million hypertensive patients (12), and sodium intake is very high across all regions in China (12 g/person/d) (13).…”