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Diabetic MAFLD is associated with increased risk of hepatocellular carcinoma and mortality in chronic viral hepatitis patients

Authors
 Mi Na Kim  ;  Kyungdo Han  ;  Juhwan Yoo  ;  Seong Gyu Hwang  ;  Xuehong Zhang  ;  Sang Hoon Ahn 
Citation
 INTERNATIONAL JOURNAL OF CANCER, Vol.153(8) : 1448-1458, 2023-10 
Journal Title
INTERNATIONAL JOURNAL OF CANCER
ISSN
 0020-7136 
Issue Date
2023-10
MeSH
Carcinoma, Hepatocellular* / epidemiology ; Chlamydia Infections* ; Diabetes Mellitus, Type 2* / complications ; Humans ; Liver Neoplasms* / epidemiology ; Non-alcoholic Fatty Liver Disease* ; Obesity / complications ; Overweight
Keywords
chronic viral hepatitis ; diabetes ; hepatocellular carcinoma ; metabolic dysfunction-associated fatty liver disease ; mortality
Abstract
Metabolic dysfunction-associated fatty liver disease (MAFLD) can coexist with chronic viral hepatitis. MAFLD is a heterogeneous disease because the diagnostic criteria include various metabolic traits. We aimed to identify patients at high risk of poor long-term outcomes based on MAFLD subgroups in chronic viral hepatitis patients. We evaluated 63 273 chronic hepatitis B and C patients. Patient with a fatty liver index ≥30 was defined to have hepatic steatosis. MAFLD was defined as the presence of hepatic steatosis with any one of the following three conditions, overweight/obesity, type 2 diabetes or ≥2 metabolic risk factors. The prevalence of MAFLD was 38.4% (n = 24 290). During a median 8.8-year follow-up, 1839 HCCs and 2258 deaths were documented in MAFLD patients. Among MAFLD patients, diabetes could identify patients at high risk of HCC and mortality, whereas overweight/obesity and metabolic risk factors did not. Compared with non-MAFLD patients, risk of HCC and mortality was significantly higher in diabetic MAFLD patients (adjusted hazard ratio [aHR] = 1.34, 95% confidence interval [CI] = 1.26-1.43 for HCC; aHR = 1.15, 95% CI = 1.08-1.22 for mortality). Risk of HCC and mortality was significantly higher in diabetic MAFLD patients (aHR = 1.40, 95% CI = 1.26-1.55 for HCC; aHR = 1.77, 95% CI = 1.63-1.93 for mortality) compared with non-diabetic MAFLD patients. Diabetic MAFLD is associated with increased risk of HCC and mortality among chronic viral hepatitis patients. Our findings highlight the need for close surveillance and effective treatment for these high-risk patients to reduce HCC and mortality in patients with chronic viral hepatitis.
Full Text
https://onlinelibrary.wiley.com/doi/10.1002/ijc.34637
DOI
10.1002/ijc.34637
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Mi Na(김미나)
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/197958
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