Metabolic syndrome and its component traits present gender-specific association with liver cancer risk: a prospective cohort study

Bin Xia,Anran Liu,Yan Tang,Changhua Zhang,Eddie C Cheung,Jinqiu Yuan,Zichong Kuo,Qiangsheng He,Kuiqing Lu,Jianjun Peng,De Toni Enrico,Die Fan,Yihang Pan,Yulong He

doi:10.1186/s12885-021-08760-1

Abstract

Background & AimsLittle is known on the gender-specific effect and potential role of non-linear associations between metabolic syndrome (MetS) components and liver cancer risk. We evaluated these associations based on the UK Biobank cohort.MethodsWe included 474,929 individuals without previous cancer based on the UK Biobank cohort. Gender-specific hazard ratios (HRs) and 95% confidence interval (CIs) were calculated by Cox proportional hazards regression, adjusting for potential confounders. Non-linear associations for individual MetS components were assessed by the restricted cubic spline method.ResultsOver a median follow-up of 6.6 years, we observed 276 cases of liver cancer (175 men, 101 women). MetS [HR 1.48, 95% CI 1.27–1.72] and central obesity [HR 1.65, 95% CI 1.18–2.31] were associated with higher risk of liver cancer in men but not in women. Participants with hyperglycaemia has higher risk of liver cancer. High waist circumference and blood glucose were dose-dependently associated with increased liver cancer risk in both genders. For high density lipoprotein (HDL) cholesterol (both genders) and blood pressure (women), U-shaped associations were observed. Low HDL cholesterol (< 1.35 mmol/L) in men and high HDL cholesterol in women (> 1.52 mmol/L) were associated with increased liver cancer risk.ConclusionsMetS components showed gender-specific linear or U- shaped associations with the risk of liver cancer. Our study might provide evidence for individualized management of MetS for preventing liver cancer.

Highlights

Liver cancer is the sixth most commonly diagnosed cancer and the third leading cause of cancer-related deaths worldwide, accounting for more than 0.91 million new cases and 0.83 million deaths per year [1]
It has been shown that subjects with metabolic syndrome (MetS) tend to have an increased hepatic insulin resistance and fat accumulation in the liver, which may increase the risk of non-alcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) [4]
Data source and study design This is a prospective study based on UK Biobank, which is on-going cohort with over 500,000 individuals aged 40– 69 years recruited throughout England, Wales, and Scotland between 2006 and 2010

Summary

Introduction

Liver cancer is the sixth most commonly diagnosed cancer and the third leading cause of cancer-related deaths worldwide, accounting for more than 0.91 million new cases and 0.83 million deaths per year [1]. Accumulating evidence suggests that MetS might play a role in hepatocarcinogenesis [5,6,7,8], the results were inconsistent, especially concerning the gender-specific effects of critical MetS components. Many studies suggest that MetS [8], metabolic risk score [9], or a prolonged duration of diabetes [10], might increase the risks of hepatocellular carcinoma (HCC), especially in males, while others did not find such associations [9, 11, 12]. Little is known on the gender-specific effect and potential role of non-linear associations between metabolic syndrome (MetS) components and liver cancer risk. We evaluated these associations based on the UK Biobank cohort

Methods

Results

Conclusion