Understanding the Role of Metabolic Syndrome as a Risk Factor for Hepatocellular Carcinoma

Chavez-Tapia, Norberto C; Gall, Sofía Murúa-Beltrán; Ordoñez-Vázquez, Ana Luisa; Nuño‐Lámbarri, Natalia; Vidal-Cevallos, Paulina; Uribe, Misael

doi:10.2147/jhc.s283840

Cited by 8 publications

(7 citation statements)

References 66 publications

(106 reference statements)

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“…A previous study has revealed that metformin treatment can inhibit HCC cell proliferation and decrease the risk of HCC development in T2DM patients ( 22 ). We also found that metformin not only can prolong the OS but also can decrease the recurrence rate for these patients ( 23 ). Furthermore, metformin can inhibit energetic metabolism including blood glucose, which may influence the proliferation and migration of HCC cells ( 24 ).…”

Section: Discussionmentioning

confidence: 64%

The effect of metformin usage on survival outcomes for hepatocellular carcinoma patients with type 2 diabetes mellitus after curative therapy

Yuan

Wang

et al. 2022

Front. Endocrinol.

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ObjectiveMetformin has attracted more attention from researchers for its newly discovered antitumor effects. A meta-analysis was performed to reveal the efficacy of metformin on overall survival (OS) and recurrence-free survival (RFS) for HCC patients with type 2 diabetes mellitus (T2DM) after curative treatment.MethodsDatabases including PubMed, the Cochrane Library, Web of Science, CNKI, Wangfang, and Weipu Database up until 31 May 2022 were searched for relevant studies. STATA 13.0 was used to perform the meta-analysis.ResultsA total of six studies involving 5,936 patients were included in our study. The results from the current study revealed that metformin usage can significantly prolong the 3-year [odds ratio (OR) = 1.50, 95% confidence interval (CI): 1.22–1.83, p = 0.000] and 5-year (OR = 1.88, 95% CI: 1.47–2.41, p = 0.000) OS and decrease the 1-year (OR = 1.31, 95% CI: 1.08–1.59, p = 0.007), 3-year (OR = 1.88, 95% CI: 1.48–2.37, p = 0.000), and 5-year (OR = 1.83, 95% CI: 1.40–2.40, p = 0.000) recurrence rates.ConclusionMetformin treatment significantly prolongs the OS and decreases the recurrence rate for HCC patients with T2DM after curative HCC therapy.

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Section: Discussionmentioning

confidence: 64%

The effect of metformin usage on survival outcomes for hepatocellular carcinoma patients with type 2 diabetes mellitus after curative therapy

Yuan

Wang

et al. 2022

Front. Endocrinol.

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“…Serum ApoB and ApoA1 decreased in CHB, HBV-associated LC, and HBV-associated HCC groups compared with healthy controls, while there were few comparative studies between the groups 21,37,38 . HBV can modulate ApoA1 function through HBx, leading to ApoA1 dysfunction (e.g., decreased self-association ability, elevated carbonyl levels, as well as impaired lipid binding ability 20,21 ).…”

Section: Discussionmentioning

confidence: 99%

Serum ApoB/ApoA1 ratio in patients with CHB and the occurrence of HBV related cirrhosis and HBV related hepatocellular carcinoma

Cai,

Peng,

Xiao

et al. 2024

Sci Rep

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Clinical research has suggested that chronic HBV infection exerts a certain effect on the occurrence of cardiovascular disease by regulating cholesterol metabolism in liver cells. High serum apolipoprotein B/apolipoprotein A1 (ApoB/ApoA1) ratio plays a certain role in the above regulation, and it serves as a risk factor for cardiovascular disease. However, whether the ApoB/ApoA1 ratio is correlated with chronic HBV infection and its disease progression remains unclear. In accordance with the inclusion and exclusion criteria, all 378 participants administrated at Renmin Hospital of Wuhan University from March 2021 to March 2022, fell into Healthy Control (HC) group (50 participants), Hepatocellular carcinoma (HCC) group (107 patients), liver cirrhosis (LC) group (64 patients), chronic hepatitis B (CHB) group (62 patients), chronic hepatitis C (CHC) group (46 patients) and Hepatitis E Virus (HEV) group (49 patients). Serum ApoA1 and ApoB concentrations were measured at admission, and the ApoB/ApoA1 ratio was determined. The levels of laboratory parameters in the respective group were compared and ApoB/ApoA1 ratios in HCC patients and LC patients with different severity were further analyzed. ROC curves were plotted to analyze the early diagnostic ability of ApoB/ApoA1 ratio for HBV-associated HCC. Logistic regression and restricted cubic spline analysis were used to explore the correlation between ApoB/ApoA1 ratio and LC and HCC risk. A comparison was drawn in terms of ApoB/ApoA1 ratio between the groups, and the result was expressed in descending sequence: HEV group > CHB group > LC group > HCC group > CHC group > HC group, early-stage HCC < middle-stage HCC < advanced-stage HCC, Class A LC < Class B LC < Class C LC. Serum ApoB/ApoA1 ratio combined diagnosis with AFP exhibited the capability of increasing the detection efficacy and specificity of AFP for HCC and AFP-negative HCC. The incidence of LC and HCC in the respective logistic regression model showed a negative correlation with the serum ApoB/ApoA1 ratio in CHB patients (P < 0.05). After all confounding factors covered in this study were regulated, the result of the restricted cubic spline analysis suggested that in a certain range, serum ApoB/ApoA1 ratio showed an inverse correlation with the prevalence of LC or HCC in CHB patients. Serum ApoB/ApoA1 ratio in CHB patients may be conducive to identifying high-risk patients for HCC or LC, such that LC and HCC can be early diagnosed and treated.

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“…Diabetes and obesity are also risk factors of HCC in NAFLD patients. 107,108 The presence of type 2 diabetes and metabolic syndrome along with diabetes increases the risk of HCC 2-fold and 5-fold, respectively, while obesity (body mass index [BMI] >30 kg/ m 2 ) and severe obesity (BMI >35 kg/m 2 ) can increase the risk of HCC 2-fold and 4-fold, respectively. 100 Inflamed visceral adipose tissue induced by obesity secretes pro-inflammatory adipocytokines such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), thereby promoting systemic inflammation and insulin resistance, further exacerbating NAFLD.…”

Section: Nafldmentioning

confidence: 99%

Perspectives on the Underlying Etiology of HCC and Its Effects on Treatment Outcomes

Ito¹,

Nguyen²

2023

JHC

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Hepatocellular carcinoma (HCC) continues to be a serious medical problem with poor prognosis worldwide. The distribution of the major etiologies of HCC is changing due to the progress of anti-viral treatments, including hepatitis B virus (HBV) suppression by nucleoside/nucleotide analogues (NAs) and increased sustained virologic response (SVR) rates by direct-acting antivirals (DAAs) for hepatitis C virus (HCV), as well as the rising trend of nonviral liver disease. Although viral hepatitis remains the most common cause of HCC, non-alcoholic liver disease (NAFLD) with metabolic syndrome and alcohol-associated liver disease (ALD) are increasing. Effective and well-tolerated NAs treatment can slow the disease progression of chronic HBV infection to cirrhosis, end-stage liver disease, and reduce HCC risk. Treatment with NAs is also associated with significant improvement in the long-term survival of patients with HBV infection who already have HCC. DAAs have achieved viral elimination in almost all patients with HCV without significant adverse events, even in patients with decompensated liver cirrhosis and HCC. Similarly, DAA therapy can reduce disease progression, liver and non-liver complications, and improve the long-term survival of patients with chronic HCV infection with or without HCC. Meanwhile, NAFLD is a rapidly increasing cause of HCC along with the epidemics of obesity and type 2 diabetes globally. NAFLD-related HCC can occur in patients without cirrhosis and is known to have a lower survival rate than viral hepatitis-related HCC. Since there is currently no specific pharmacotherapy effective for NAFLD, lifestyle modification and prevention of complications are important to improve prognosis. Additionally, ALD is the second fastest-growing cause of HCCrelated deaths, especially with an accelerated trend since the COVID-19 pandemic. This review provides an overview of the epidemiologic trends in the etiologies of HCC, and the progress of treatments for each etiology and the impact on outcome in the patients with HCC.

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Understanding the Role of Metabolic Syndrome as a Risk Factor for Hepatocellular Carcinoma

Cited by 8 publications

References 66 publications

The effect of metformin usage on survival outcomes for hepatocellular carcinoma patients with type 2 diabetes mellitus after curative therapy

The effect of metformin usage on survival outcomes for hepatocellular carcinoma patients with type 2 diabetes mellitus after curative therapy

Serum ApoB/ApoA1 ratio in patients with CHB and the occurrence of HBV related cirrhosis and HBV related hepatocellular carcinoma

Perspectives on the Underlying Etiology of HCC and Its Effects on Treatment Outcomes

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