Raxitkumar Jinjuvadia1, Suhag Patel, Suthat Liangpunsakul. 1. *Department of Internal Medicine, Detroit Medical Center/Wayne State University, Detroit, MI †Department of Medicine, Division of Gastroenterology and Hepatology, Indiana University Medical Center ‡Roudebush Veterans Administration Medical Center, Indianapolis, IN.
Abstract
BACKGROUND: The metabolic syndrome (MetS) and/or its individual components have been linked to the development of cancer. Recent studies have suggested a similar link to hepatocellular carcinoma (HCC). The aim of this study was to evaluate the direction and magnitude of the association between the MetS and HCC. METHODS: Two reviewers independently conducted a systemic search to identify the available evidence from databases from January 1980 to June 2012. Search terms included "Metabolic syndrome," "insulin resistance syndrome," "metabolic abnormalities" combined with "hepatocellular carcinoma," and "liver cancer." No language restriction was applied to the search. Only studies reporting an effect measure for the association between MetS and HCC were eligible for inclusion. Publication bias was assessed using the Begg and Egger tests, with a visual inspection of funnel plot. All analyses were performed using Comprehensive Meta-analysis version 2 software. RESULTS: Four studies (3 cohort and 1 case control) with a total of 829,651 participants were included in the analysis. The age range of participants was between 30 and 84 years. The combined analysis showed an overall 81% increased risk of HCC in cases with MetS (relative risk, 1.81; 95% confidence interval, 1.37-2.41). After excluding the single case-control study from analysis, the overall risk ratio remained statistically significant (relative risk, 1.49; 95% confidence interval, 1.27-1.74). Funnel plot inspection, Begg and Egger tests showed no evidence of publication bias for combined analysis. CONCLUSIONS: Though studies are scarce, currently available epidemiologic data are suggestive of significantly higher risk of HCC among patients with MetS.
BACKGROUND: The metabolic syndrome (MetS) and/or its individual components have been linked to the development of cancer. Recent studies have suggested a similar link to hepatocellular carcinoma (HCC). The aim of this study was to evaluate the direction and magnitude of the association between the MetS and HCC. METHODS: Two reviewers independently conducted a systemic search to identify the available evidence from databases from January 1980 to June 2012. Search terms included "Metabolic syndrome," "insulin resistance syndrome," "metabolic abnormalities" combined with "hepatocellular carcinoma," and "liver cancer." No language restriction was applied to the search. Only studies reporting an effect measure for the association between MetS and HCC were eligible for inclusion. Publication bias was assessed using the Begg and Egger tests, with a visual inspection of funnel plot. All analyses were performed using Comprehensive Meta-analysis version 2 software. RESULTS: Four studies (3 cohort and 1 case control) with a total of 829,651 participants were included in the analysis. The age range of participants was between 30 and 84 years. The combined analysis showed an overall 81% increased risk of HCC in cases with MetS (relative risk, 1.81; 95% confidence interval, 1.37-2.41). After excluding the single case-control study from analysis, the overall risk ratio remained statistically significant (relative risk, 1.49; 95% confidence interval, 1.27-1.74). Funnel plot inspection, Begg and Egger tests showed no evidence of publication bias for combined analysis. CONCLUSIONS: Though studies are scarce, currently available epidemiologic data are suggestive of significantly higher risk of HCC among patients with MetS.
Authors: Hanna-Maaria Lakka; David E Laaksonen; Timo A Lakka; Leo K Niskanen; Esko Kumpusalo; Jaakko Tuomilehto; Jukka T Salonen Journal: JAMA Date: 2002-12-04 Impact factor: 56.272
Authors: Vincent Wai-Sun Wong; Jun Yu; Alfred Sze-Lok Cheng; Grace Lai-Hung Wong; Hoi-Yun Chan; Eagle Siu-Hong Chu; Enders Kai-On Ng; Francis Ka-Leung Chan; Joseph Jao-Yao Sung; Henry Lik-Yuen Chan Journal: Int J Cancer Date: 2009-06-15 Impact factor: 7.396
Authors: Krasimira Aleksandrova; Heiner Boeing; Mazda Jenab; H Bas Bueno-de-Mesquita; Eugene Jansen; Fränzel J B van Duijnhoven; Veronika Fedirko; Sabina Rinaldi; Isabelle Romieu; Elio Riboli; Dora Romaguera; Kim Overvad; Jane Nautrup Østergaard; Anja Olsen; Anne Tjønneland; Marie-Christine Boutron-Ruault; Françoise Clavel-Chapelon; Sophie Morois; Giovanna Masala; Claudia Agnoli; Salvatore Panico; Rosario Tumino; Paolo Vineis; Rudolf Kaaks; Annekatrin Lukanova; Antonia Trichopoulou; Androniki Naska; Christina Bamia; Petra H Peeters; Laudina Rodríguez; Genevieve Buckland; María-José Sánchez; Miren Dorronsoro; Jose-María Huerta; Aurelio Barricarte; Göran Hallmans; Richard Palmqvist; Kay-Tee Khaw; Nicholas Wareham; Naomi E Allen; Konstantinos K Tsilidis; Tobias Pischon Journal: Cancer Prev Res (Phila) Date: 2011-06-22
Authors: Trang VoPham; Kimberly A Bertrand; Jaime E Hart; Francine Laden; Maria M Brooks; Jian-Min Yuan; Evelyn O Talbott; Darren Ruddell; Chung-Chou H Chang; Joel L Weissfeld Journal: Cancer Causes Control Date: 2017-02-13 Impact factor: 2.506
Authors: Tracey G Simon; Lindsay Y King; Dawn Q Chong; Long H Nguyen; Yanan Ma; Trang VoPham; Edward L Giovannucci; Charles S Fuchs; Jeffrey A Meyerhardt; Kathleen E Corey; Hamed Khalili; Raymond T Chung; Xuehong Zhang; Andrew T Chan Journal: Hepatology Date: 2018-03-26 Impact factor: 17.425