Abstract
Among risk factors (apart from smoking) likely involved in bladder cancer (BCa), metabolic syndrome (MS), obesity and type 2 diabetes mellitus (T2DM) have been explored with contrasting results. In spite of these studies, there is little data on the association between nonalcoholic fatty liver disease (NAFLD), its main driver, i.e., insulin resistance (IR), and BCa. Implanting a cross-sectional retrospective study we tried to investigate both NAFLD and IR prevalence in a hospital based population of BCa patients. We studied laboratory data from 204 patients with histologically confirmed non metastatic BCa and 50 subjects with no BCa, but with bladder diseases (no Ca BD). We evaluated the presence of NAFLD by the triglycerides/glucose Index (TyG Index), using a cut-off of 0.59 and by the Aspartate Aminotransferase/Alanine Aminotransferase AST/ALT ratio. IR was assessed by the same TyG Index (cut-off 4.68) and the triglycerides/High-Density Lipoprotein HDL ratio (cut-off 2.197). The diagnosis of impaired fasting glucose (IFG), condition of prediabetes, as well as that of T2DM was assessed according to canonical guidelines. The TyG Index predicted NAFLD presence in both groups (p = 0.000), but the BCa group showed a major percentage of NAFLD cases with respect to no Ca BD group (59% versus 40%). A greater proportion of IR (47%) in BCa group than in no Ca BD one (37%) was evidenced by the TyG Index with its median value significantly different (p = 0.0092). This high rate of IR in the BCa group was confirmed by the triglycerides/HDL ratio (p = 0.02). Prediabetes and T2DM were more prevalent in the BCa group than no Ca BD group (p = 0.024). In this study a consistent NAFLD presence was found in BCa patients. This is an important comorbidity factor that deserves further consideration in prospective studies. The higher prevalence of NAFLD, IR, prediabetes and T2DM in the BCa group evidences the need that these disorders should be reckoned as adjunct factors that could impact on this cancerous disease.
Highlights
The higher prevalence of nonalcoholic fatty liver disease (NAFLD), insulin resistance (IR), prediabetes and type 2 diabetes mellitus (T2DM) in the Bladder cancer (BCa) group evidences the need that these disorders should be reckoned as adjunct factors that could impact on this cancerous disease
More than two-thirds of patients present with superficial tumours that are reckoned as Non Muscle-Invasive Bladder Cancer (NMIBC), [2], while in stage T2a the tumour has spread to the inner half of the muscle of the bladder wall
In this study the high prevalence of NAFLD, coupled with the high rate of IR in the BCa group, prompts physicians to consider this disorder an important comorbidity that could impact on this cancerous disease
Summary
More than two-thirds of patients present with superficial tumours (stages Ta and T1) that are reckoned as Non Muscle-Invasive Bladder Cancer (NMIBC), [2], while in stage T2a the tumour has spread to the inner half of the muscle of the bladder wall. It is important to know about determinants for BCa because there may be modifiable factors that might lower cancer susceptibility and prognosis. Other risk factors for BCa have been studied, including metabolic syndrome (MS), obesity, and type 2 diabetes mellitus (T2DM) [3,4,5]. Still, analysing a vast population, data do not support an association of T2DM with overall bladder cancer incidence from 1992 through 2007 [10]. At our best knowledge there is few data on NAFLD and IR in BCa patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
