MASLD and MetALD increase the risk of developing hepatocellular carcinoma and incident or decompensated cirrhosis: a Korean nationwide study

IF 11.6 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Liver Cancer Pub Date : 2023-12-22 DOI:10.1159/000535943
Gi-Ae Kim, Seogsong Jeong, Heejoon Jang, Dong Hyeon Lee, S. Joo, Won Kim
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引用次数: 0

Abstract

Introduction: This study aimed to investigate the liver-related outcomes of newly suggested metabolic dysfunction-associated steatotic liver disease (MASLD) and MASLD with increased alcohol intake (MetALD), as well as alcohol-associated liver disease (ALD). Methods: From a National Health Insurance Service Health Screening Cohort, we included 369,094 participants who underwent health check-ups between 2009 and 2010 in South Korea. SLD was defined as a fatty liver index ≥60. The risk of primary liver cancer (PLCa), hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (iCCA), incident cirrhosis, and decompensated cirrhosis was compared with no steatotic liver disease (SLD). The subdistribution hazard ratio (SHR) was calculated using the Fine–Gray model regarding competing risks. Results: A total of 3,232 participants (0.9%) developed PLCa during the median follow-up of 3,227,176 person-years: 0.5% with no SLD, 1.1% with MASLD, 1.3% with MetALD, and 1.9% with ALD. Competing risk analysis revealed that compared with no SLD, MASLD (SHR, 1.65; 95% CI, 1.44−1.88), MetALD (SHR, 1.87; 95% CI, 1.52−2.29), and ALD (SHR, 1.86; 95% CI, 1.39−2.49) were associated with an increased risk of PLCa. MASLD (SHR, 1.96; 95% CI, 1.67−2.31), MetALD (SHR, 2.23; 95% CI, 1.75−2.84), and ALD (SHR, 2.34; 95% CI, 1.67−3.29) were associated with a higher risk of HCC. No significant difference was observed in the risk of iCCA. The risk of incident cirrhosis and decompensated cirrhosis increased in the order of no SLD, MASLD, MetALD, and ALD. Conclusion: MASLD, MetALD, and ALD have an increased risk of PLCa, HCC, incident cirrhosis, and decompensated cirrhosis but not iCCA. These findings may serve as a robust ground for the prognostic value of the newly suggested MASLD and MetALD.
MASLD和MetALD会增加罹患肝细胞癌和偶发或失代偿性肝硬化的风险:一项韩国全国性研究
简介本研究旨在调查新提出的代谢功能障碍相关性脂肪性肝病(MASLD)、代谢功能障碍伴酒精摄入量增加的脂肪性肝病(MetALD)以及酒精相关性肝病(ALD)的肝脏相关结果:我们从韩国国民健康保险服务健康检查队列中纳入了 369,094 名在 2009 年至 2010 年期间接受健康检查的参与者。SLD定义为脂肪肝指数≥60。将原发性肝癌(PLCa)、肝细胞癌(HCC)、肝内胆管癌(iCCA)、肝硬化和失代偿期肝硬化的发病风险与无脂肪肝(SLD)进行了比较。采用Fine-Gray竞争风险模型计算亚分布危险比(SHR):结果:在 3,227,176 人年的中位随访期间,共有 3,232 名参与者(0.9%)罹患 PLCa:0.5%未患SLD,1.1%患MASLD,1.3%患MetALD,1.9%患ALD。竞争风险分析显示,与无 SLD 相比,MASLD(SHR,1.65;95% CI,1.44-1.88)、MetALD(SHR,1.87;95% CI,1.52-2.29)和 ALD(SHR,1.86;95% CI,1.39-2.49)与 PLCa 风险增加有关。MASLD(SHR,1.96;95% CI,1.67-2.31)、MetALD(SHR,2.23;95% CI,1.75-2.84)和ALD(SHR,2.34;95% CI,1.67-3.29)与较高的 HCC 风险相关。在 iCCA 风险方面未观察到明显差异。发生肝硬化和失代偿性肝硬化的风险依次为无SLD、MASLD、MetALD和ALD:结论:MASLD、MetALD 和 ALD 会增加 PLCa、HCC、肝硬化和失代偿期肝硬化的风险,但不会增加 iCCA 的风险。这些发现为新提出的 MASLD 和 MetALD 的预后价值提供了坚实的基础。
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来源期刊
Liver Cancer
Liver Cancer Medicine-Oncology
CiteScore
20.80
自引率
7.20%
发文量
53
审稿时长
16 weeks
期刊介绍: Liver Cancer is a journal that serves the international community of researchers and clinicians by providing a platform for research results related to the causes, mechanisms, and therapy of liver cancer. It focuses on molecular carcinogenesis, prevention, surveillance, diagnosis, and treatment, including molecular targeted therapy. The journal publishes clinical and translational research in the field of liver cancer in both humans and experimental models. It publishes original and review articles and has an Impact Factor of 13.8. The journal is indexed and abstracted in various platforms including PubMed, PubMed Central, Web of Science, Science Citation Index, Science Citation Index Expanded, Google Scholar, DOAJ, Chemical Abstracts Service, Scopus, Embase, Pathway Studio, and WorldCat.
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