Association between metabolic risk factors and hepatocellular carcinoma: a systematic review and meta-analysis of cohort studies
Abstract
Background: Considerable evidence suggests that hepatocellular carcinoma (HCC) is tightly related to metabolic disorders. However, it is not yet clear which metabolic risk factors play a critical role in hepatocarcinogenesis.
Methods: We searched Pubmed, Embase, and Web of Science from inception up to April 29, 2023. The hazard ratio (HR) and the corresponding 95% confidence interval (95%CI) were used to assess the pooled risk.
Results: Seventy-three studies involving more than 45 million participants were included. Among the metabolic risk factors: metabolic syndrome (MetS) (HR = 1.80, 95%CI: 1.44-2.25), diabetes mellitus (DM) (HR = 2.01, 95%CI: 1.79-2.27), body mass index (BMI) ≥ 24 kg/m2 (HR = 1.47, 95%CI: 1.35-1.61), waist circumference (WC) (HR = 1.39, 95%CI: 1.26-1.55), waist-to-hip ratio (WHR) (HR = 1.33, 95%CI: 1.16-1.52), waist-to-height ratio (WHtR) (HR = 2.23, 95%CI: 1.42-3.51), reduced triglyceride (TG) (HR = 1.36, 95%CI: 1.09-1.69) and hypertension (HR = 1.43, 95%CI: 1.13-1.81) were positively associated with HCC risk. The disturbances of high-density lipoprotein cholesterol (HDL-C) levels (elevated, HR = 0.88, 95%CI: 0.81-0.96; reduced, HR = 0.96, 95%CI: 0.93-0.99) and elevated low-density lipoprotein cholesterol (LDL-C) (HR = 0.44, 95%CI: 0.32-0.62) were consistently associated with decreased risk of HCC. Nevertheless, elevated total cholesterol (TC) (HR = 0.87, 95%CI: 0.69-1.10) and elevated TG (HR = 0.72, 95%CI: 0.36-1.43) were not significantly associated…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 45 participants or records.
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