Risk of hepatic and extrahepatic cancer in <scp>NAFLD</scp>: A population‐based cohort study

Björkström, Karl; Widman, Linnea; Hagström, Hannes

doi:10.1111/liv.15195

Cited by 39 publications

(33 citation statements)

References 36 publications

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“…If left untreated, NAFLD can progress to liver cirrhosis and hepatocellular carcinoma ( 2 ). Furthermore, NAFLD is associated with extrahepatic complications, particularly cardiovascular disease and certain cancers ( 3 , 4 ). Although weight loss and lifestyle modification behaviors are the first therapeutic approach to prevent NAFLD, or prevent the progression of NAFLD, most patients do not easily adhere to this approach ( 5 , 6 ).…”

Section: Introductionmentioning

confidence: 99%

Effect of pemafibrate on liver enzymes and shear wave velocity in non-alcoholic fatty liver disease patients

et al. 2023

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Background/AimsPemafibrate is a selective peroxisome proliferator-activated receptor α modulator that improves serum alanine aminotransferase (ALT) in dyslipidemia patients. Pemafibrate was reported to reduce ALT in non-alcoholic fatty liver disease (NAFLD) patients, but efficacy was not clearly elucidated due to the small size of previous study populations. Therefore, we explored pemafibrate efficacy in NAFLD patients.MethodsWe retrospectively evaluated pemafibrate efficacy on liver enzymes (n = 132) and liver shear wave velocity (SWV, n = 51) in NAFLD patients who had taken pemafibrate for at least 24 weeks.ResultsPatient ALT levels were decreased from 81.0 IU/L at baseline to 48.0 IU/L at week 24 (P < 0.0001). Serum levels of aspartate aminotransferase (AST), γ-glutamyl transpeptidase (γ-GTP) and triglyceride (TG) were significantly decreased, and high-density lipoprotein cholesterol and platelet count were significantly increased, with no change in body weight being observed. Study participant SWV values decreased from 1.45 m/s at baseline to 1.32 m/s at week 48 (P < 0.001). Older age (P = 0.035) and serum TG levels (P = 0.048) were significantly associated with normalized ALT. Changes in AST, ALT, γ-GTP and body weight were significantly correlated with change in SWV.ConclusionPemafibrate significantly improves liver function, serum TG and liver stiffness in NAFLD patients. Pemafibrate is a promising therapeutic agent for NAFLD and may be a candidate for NAFLD patients with elevated TG.

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Section: Introductionmentioning

confidence: 99%

Effect of pemafibrate on liver enzymes and shear wave velocity in non-alcoholic fatty liver disease patients

et al. 2023

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“…Regarding extrahepatic malignancies, colorectal cancers 1.4 (95% CI 1.1-1.7)/1000 person-years, breast cancers 1.2 (95% CI 1.0-1.6)/1000 person-years, and prostate cancers 1.3 (95% CI 1.0-1.7)/1000 personyears have been reported. [27] In this study, gastrointestinal cancers, gynecologic cancers, and urinary cancers were detected in the M/N group, non-gastrointestinal cancers in the non-M/N, and gastrointestinal cancers in the M/non-N group. The incidence of extrahepatic malignancies was nonsigni cantly lower in the non-M/N and M/non-N groups (p = 0.49).…”

Section: Discussionmentioning

confidence: 50%

Outcomes of fatty liver disease with and without metabolic comorbidities and risk factors for mortality

Ogasawara

Kogiso

Horiuchi

et al. 2022

Preprint

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Aims Patients with fatty liver disease (FLD) frequently have metabolic risk factors; however, the clinical course of metabolic-associated FLD (MAFLD) in Asians is unclear. We compared the clinical courses of MAFLD and nonalcoholic FLD (NAFLD). Methods Asian FLD patients (n = 987) from 1991–2021 (biopsy-proven in 939, 497 males) were enrolled. The patients were divided into non-MAFLD/NAFLD (non-M/N, n = 92), both M/N (n = 785), and M/non-N (n = 90) groups. The clinical features, complications, and survival rates were compared among the three groups. Mortality risk factors were subjected to Cox regression analysis. Results 1) Non-M/N patients were significantly younger (non-M/N, M/N, and M/non-N 50, 53, and 57 years, respectively), more frequently male (54.3, 52.6, and 37.8%), and had a low body mass index (BMI, 23.1, 27.1, and 26.7 kg/m2) and FIB-4 index (1.20, 1.46, and 2.10). Hypopituitarism (5.4%) and hypothyroidism (7.6%) were significantly observed in the non-M/N group. Hepatocellular carcinoma (HCC) developed in 0.0, 4.2, and 3.3% of the cases, and extrahepatic malignancies in 6.8, 8.4, and 4.7% of the cases, respectively, with no significant differences. The cardiovascular event rate was significantly higher in the M/non-N group (1, 37, and 11 cases, p < 0.01). Survival rates were not significantly different among the three groups. 2) The risk factors for mortality were age and BMI in the non-M/N group; age, HCC, alanine transaminase, and FIB-4 in the M/N group; and FIB-4 in the M/non-N group. Conclusions Although there was no significant difference in survival rates among the three groups of FLD, it should be considered that there would be different risk factors for mortality among the groups.

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“… 11 In a recent analysis an HCC incidence rate of 0.8/1000 person‐years (95% CI 0.6–1.1) was reported for NAFLD (+/− liver cirrhosis) yielding a HR of 15.50 (95% CI 9.92–24.21). 12 In the current study, the incidence rate was 21.6 (95% CI 18.8–24.8). In conclusion, the study by Bengtsson et al.…”

mentioning

confidence: 47%

“…In additional barrier is the lower sensitivity of ultrasound in obese patients 11 . In a recent analysis an HCC incidence rate of 0.8/1000 person‐years (95% CI 0.6–1.1) was reported for NAFLD (+/− liver cirrhosis) yielding a HR of 15.50 (95% CI 9.92–24.21) 12 . In the current study, the incidence rate was 21.6 (95% CI 18.8–24.8).…”

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confidence: 99%

The unmet need of personalized HCC screening—Lessons learned from the Swedish nationwide registries

Gairing

Schattenberg

2022

UEG Journal

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The unmet need of personalized HCC screening-Lessons learned from the Swedish nationwide registries Primary liver cancer is the third leading cause of cancer-associated death worldwide and represents a global public health burden. 1 Hepatocellular carcinoma (HCC) accounts for approximately 80% of primary liver cancer cases. 1 While liver cirrhosis is the most important risk factor, the HCC risk is dependent on the underling etiology, gender and additional cofactors. 2 All of these have to be consider when recommending surveillance strategies and assessing (cost-)effectiveness.In the current study, Bengtsson et al. explored the HCC risk in patients with liver cirrhosis in the Swedish nationwide health registry. 3 The overall incidence rate of HCC was 23/1000 person-years (95% CI 22-24) in 15,215 cases with liver cirrhosis. The cumulative incidence rate at 10 years was 12.2% (95% CI 11.6-13.0). Men had a higher overall incidence rate of 29/1000 person-years (95% CI 27-31) compared to 14/1000 person-years (95% CI 13-16) in women.The highest incidence rate 41/1000 person-years (95% CI 38-45) was seen in patients with chronic viral hepatitis. In contrast, the lowest incidence rate (15/1000 person-years (95% CI 13-16)) was observed in patients with alcoholic liver disease (ALD). Stratified by sex, men with viral-related HCC had the highest (26.6%), women with ALD-related HCC the lowest (4.3%) cumulative incidence at 10 years.The strength of this study is the long follow-up in the Swedish National Outpatient Registry that allows to assess the overall mortality and the impact of liver disease which is occurring slowly over time. The study provides valuable insights and is highly relevant for routine clinical practice. Current European guidelines recommend HCC surveillance for all patients with Child-Pugh A and B cirrhosis independent of the underlying etiology, sex or age. 2 In general, an incidence rate of ≥1.5%/year is considered to be cost-effective. 2,4 et al. provides important clinical insight and urges the field to implement personalized surveillance strategies for HCC.

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

Cited by 39 publications

References 36 publications

Effect of pemafibrate on liver enzymes and shear wave velocity in non-alcoholic fatty liver disease patients

Effect of pemafibrate on liver enzymes and shear wave velocity in non-alcoholic fatty liver disease patients

Outcomes of fatty liver disease with and without metabolic comorbidities and risk factors for mortality

The unmet need of personalized HCC screening—Lessons learned from the Swedish nationwide registries

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