Extrahepatic Malignancies in Nonalcoholic Fatty Liver Disease
- PDF / 991,792 Bytes
- 18 Pages / 595.276 x 790.866 pts Page_size
- 83 Downloads / 229 Views
FATTY LIVER DISEASE (V AJMERA, SECTION EDITOR)
Extrahepatic Malignancies in Nonalcoholic Fatty Liver Disease Omar T. Ahmed 1 & Alina M. Allen 1
# Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Purpose of Review Malignancy is the second most common cause of death in individuals with nonalcoholic fatty liver disease (NAFLD). Understanding unique characteristics of malignancy risk beyond hepatocellular carcinoma in NAFLD has significant implications in counseling and personalized preventative measures in this high-risk population. Herein, we systematically review the literature reporting extra-hepatic malignancies in NAFLD and discuss the key biological mechanisms underpinning the association between excess adiposity and cancer risk. Recent Findings Several studies have shown significant associations between NAFLD and extrahepatic malignancies. The strongest association was found with cancers of the gastrointestinal tract and hormone-sensitive cancers. Recent data support sex-specific differences in cancer risk increase in NAFLD: colorectal cancer in men and uterine cancer in women. The risk of cancer development is higher in NAFLD than obesity alone. Summary A growing body of observational evidence over the last decade supports the association between NAFLD and extrahepatic malignancies. This association requires further studies, ideally designed to include more detailed measures of body fat deposition beyond BMI in well-characterized, large cohorts of NAFLD patients, to determine if screening policies should be individualized in this group. Keywords Cancer . Malignancy . NAFLD . Epidemiology . Obesity
Abbreviations aHR Adjusted hazard ratio aOR Adjusted odds ratio aRR Adjusted relative risk BMI Body mass index CI Confidence interval CRC Colorectal cancer CRP C-reactive protein CT Computed tomography FIB-4 Fibrosis-4 index FLI Fatty liver index GI Gastrointestinal HIS Hepatic steatosis index HR Hazard ratio ICD International Classification of Diseases IL Interleukin IR Insulin resistance * Alina M. Allen [email protected] 1
Department of Internal Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA
IRR LT MetS MRI MRS NAFLD NASH OR SIR TNF US
Incidence rate ratio Liver transplant Metabolic syndrome Magnetic resonance imaging Magnetic resonance spectroscopy Nonalcoholic fatty liver disease Nonalcoholic steatohepatitis Odds ratio Standardized incidence ratio Tumor necrosis factor Ultrasound
Introduction Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide, with an estimated global prevalence of 25% in adults [1–3]. NAFLD is more predominant in those with obesity and metabolic syndrome (MetS) [4]. In North America, the prevalence of NAFLD in the severely obese ranges from 75 to 92%, while the prevalence in patients with type 2 diabetes is estimated to be between 60 and 70% [5–11]. Obesity has become one of the largest public health
Curr Hepatology Rep
threats. Strong evidence
Data Loading...
