Non-alcoholic fatty liver disease and the risk of malignant tumors

Abstract

The prevalence of non-alcoholic fatty liver disease (NAFLD) and metabolic associated liver disease (MAFLD) is growing world-wide. A new terminology (MAFLD) allows us not only to focus on the “metabolic” genesis of this pathology, but also to take into account other factors affecting damage to hepatocytes, such as alcohol consumption in low doses, viral and toxic hepatitis. Currently, obesity is a pathology, that is growing with MAFLD and causes of various non-communicable diseases. Most deaths in patients with NAFLD/MAFLD are caused, firstly, by adverse cardiovascular events, secondly, by malignant tumors of both the digestive organs (liver, intestine, esophagus, stomach and pancreas) and other localizations (kidney cancer in men, breast cancer in women) and, thirdly, by development of hepatic complications (cirrhosis, hepatocellular carcinoma – HCC). Because of the pandemic growth of MAFLD and its association with cardiovascular diseases and obesity, the question about properly clinical management of patients suffered from comorbid pathology to reduce the risks of deaths is timely and very relevant. This review has been prepared to systematize the available literature dates about association of NAFLD/MAFLD with the malignant tumors. A literature searches were conducted, modern epidemiological dates about the prevalence of NAFLD/MAFLD in the population and their complicated forms were presented. The risk of HCC formation both with and without cirrhosis in NAFLD was assessed. It was found that the severity of liver fibrosis can be useful predictor of the future risk of not only the adverse cardiovascular events, but also the malignant tumors in patients with NAFLD/MAFLD. Possible targets for treatment were discussed, the impact on which is useful for the treatment and prevention of progressive forms of the disease. One of the possible therapeutic molecules is essential phospholipids, which are currently included in the consent documents for the managment of patients with NAFLD.