The relationship between metabolic dysfunction-associated fatty liver disease and the incidence rate of extrahepatic cancer

Abstract

BackgroundThe associations between metabolic dysfunction-associated fatty liver disease (MAFLD) and cancer development, especially extrahepatic cancers, are unknown. The aims of the current study were to investigate the cancer incidence rates of MAFLD and analyze the associations between MAFLD and the development of cancers.MethodsThis historical cohort study included participants who underwent ultrasonographic detection of hepatic steatosis at a tertiary hospital in China from January 2013 to October 2021. MAFLD was diagnosed in accordance with The International Expert Consensus Statement. Cox proportional hazards regression modeling was used to assess the associations between MAFLD and the development of cancers.ResultsOf the 47,801 participants, 16,093 (33.7%) had MAFLD. During the total follow-up of 175,137 person-years (median 3.3 years), the cancer incidence rate in the MAFLD group was higher than that in the non-MAFLD group [473.5 vs. 255.1 per 100,000 person-years; incidence rate ratio 1.86; 95% confidence interval (CI) 1.57–2.19]. After adjustment for age, gender, smoking status, and alcohol status, MAFLD was moderately associated with cancers of the female reproductive system/organs (labium, uterus, cervix, and ovary) [hazard ratio (HR) 2.24; 95% CI 1.09–4.60], thyroid (HR 3.64; 95% CI 1.82–7.30), and bladder (HR 4.19; 95% CI 1.15–15.27) in the total study cohort.ConclusionMAFLD was associated with the development of cancers of the female reproductive system/organs (labium, uterus, cervix, and ovary), thyroid, and bladder in the total study cohort.

From nonalcoholic steatohepatitis, metabolic dysfunction-associated fatty liver disease, to steatotic liver disease: Updates of nomenclature and impact on clinical trials

“…Other reports also demonstrated an increased cardiovascular mortality of patients with MAFLD as compared to NAFLD [ 9 ]. Similar results were also found in the risk of all types of cancers [ 10 ]. That means the transition from NAFLD to MAFLD helps identify more subjects who are at risk of extrahepatic events, and further promotes the surveillance of extrahepatic diseases in clinical practice.…”

Association between metabolic dysfunction-associated steatotic liver disease and risk of incident pancreatic cancer: a systematic review and meta-analysis of cohort studies

“…The number of people in the studies varied from 10,545 to 9,718,182. For the diagnosis of fatty liver, two studies ( 26 , 28 ) used ICD codes, two studies ( 31 , 32 ) utilized FLI, four studies ( 27 , 30 , 33 , 34 ) employed USG, and only one study ( 29 ) relied on liver biopsy. Most studies for confirming pancreatic cancer utilize ICD codes.…”

“…All studies revealed that confounders were taken into account ( Supplementary Table S2 ). Four studies ( 29 , 31 , 32 , 34 ) with a NOS score of 9 stars were considered to be of high quality, while five studies ( 26 – 28 , 30 , 33 ) with a NOS score of 7 or 8 stars were judged to be of medium quality in terms of methodological quality assessment (see Supplementary Table S3 for further details).…”

Metabolic dysfunction‐associated fatty liver disease in the elderly with diabetic foot ulcers: A longitudinal cohort study

“…Family and community care of DFUs associated with MAFLD are essential links for rehabilitating diabetes foot ulcers. In addition, a previous study has demonstrated an independent relationship between MAFLD and an increased risk of cardiovascular disease (CVD), chronic kidney disease (CKD), cardiac remodelling, and cancer 19–21 . It follows that MAFLD must also be related to long‐term outcomes of T2DM, such as DFUs.…”

“…In addition, a previous study has demonstrated an independent relationship between MAFLD and an increased risk of cardiovascular disease (CVD), chronic kidney disease (CKD), cardiac remodelling, and cancer. 19 , 20 , 21 It follows that MAFLD must also be related to long‐term outcomes of T2DM, such as DFUs. Therefore, exploring the association between MAFLD and DFUs is essential.…”