Peng Yu, Wang Peng, Liu Fubin, Wang Xixuan, Si Changyu, Gong Jianxiao, Zhou Huijun, Gu Jiale, Qin Ailing, Song Weijie, Song Fangfang
Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Prevention and Control of Major Diseases in the Population, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, Tianjin, China.
Department of Laboratory Animal Center, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, Tianjin, China.
Diabetes Obes Metab. 2025 Apr;27(4):1940-1949. doi: 10.1111/dom.16186. Epub 2025 Jan 9.
Fatty liver disease may be associated with increased risks of intrahepatic and extrahepatic cancers. Our objective was to investigate associations between new subcategories of steatotic liver disease (SLD) recently proposed by nomenclature consensus group and cancer risk.
A total of 283 238 participants from the UK Biobank were included. Based on information on cardiometabolic factors, alcohol consumption and the specific aetiology of SLD, individuals were categorized into four groups: no SLD (n = 170 885), metabolic dysfunction-associated steatotic liver disease (MASLD, n = 74 510), MASLD with increased alcohol intake (MetALD, n = 23 320) and other SLD (n = 6718). Outcomes were overall incident cancer (n = 39 352) and 21 site-specific cancers. The Cox proportional hazards model was used to estimate relationships between subcategories of SLD and cardiometabolic factors in MASLD with cancer risk. Population attributable risk (PAR) of cancer associated with SLD was estimated.
MASLD was the most prevalent SLD in the general population. All SLD subcategories were associated with elevated risks of overall cancer, digestive system cancers (except gastric cancer) and breast cancer (HRs 1.079-4.663). Additionally, MASLD was associated with increased risks of renal cancer, endometrial cancer and Hodgkin lymphoma. Compared to MetALD and other SLDs, MASLD has a higher PAR% for the majority of aforementioned cancers. This could be largely explained by its common metabolic abnormalities, dominantly characterized by overweight/obesity and elevated blood pressure, concomitant with hyperglycaemia and hyperlipidaemia.
All subcategories of SLD, particularly MASLD with multiple metabolic abnormalities, were associated with increased risks of multiple cancers, providing a new perspective for cancer prevention.
脂肪性肝病可能与肝内和肝外癌症风险增加有关。我们的目的是研究命名共识小组最近提出的脂肪性肝病（SLD）新亚类与癌症风险之间的关联。
纳入了英国生物银行的283238名参与者。根据心血管代谢因素、饮酒情况和SLD的特定病因信息，将个体分为四组：无SLD（n = 170885）、代谢功能障碍相关脂肪性肝病（MASLD，n = 74510）、酒精摄入量增加的MASLD（MetALD，n = 23320）和其他SLD（n = 6718）。结局指标为总体新发癌症（n = 39352）和21种特定部位癌症。采用Cox比例风险模型估计SLD亚类与MASLD中与癌症风险相关的心血管代谢因素之间的关系。估计了与SLD相关的癌症的人群归因风险（PAR）。
MASLD是普通人群中最常见的SLD。所有SLD亚类均与总体癌症、消化系统癌症（胃癌除外）和乳腺癌风险升高相关（风险比1.079 - 4.663）。此外，MASLD与肾癌、子宫内膜癌和霍奇金淋巴瘤风险增加相关。与MetALD和其他SLD相比，MASLD对大多数上述癌症的PAR%更高。这在很大程度上可以由其常见的代谢异常来解释，主要特征为超重/肥胖和血压升高，同时伴有高血糖和高血脂。
SLD的所有亚类，尤其是具有多种代谢异常的MASLD，均与多种癌症风险增加相关，为癌症预防提供了新的视角。
