ArticleHepatology (Baltimore, Md.)2020
Diabetes Is Associated With Increased Risk of Hepatocellular Carcinoma in Patients With Cirrhosis From Nonalcoholic Fatty Liver Disease.
Article in Hepatology (Baltimore, Md.), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 109 papers, 10 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
109 citing papers in PubMed, 10 syntheses or guidelines pooled it, 205 citations in OpenAlex.
- Global epidemiology of diabetes and prediabetes in lean or non-obese patients with NAFLD: a systematic review and meta-analysis.Annals of medicine · 2026Pooled it
- Association between metabolic risk factors and hepatocellular carcinoma: a systematic review and meta-analysis of cohort studies.Frontiers in medicine · 2026Pooled it
- Recent Advancements in Known and Emerging Risk Factors of Hepatocellular Carcinoma.Cancer medicine · 2025Pooled it
- Pooled it
- Inverse association between serum lipid profiles and hepatocellular carcinoma risk: a meta-analysis of epidemiological studies.Frontiers in oncology · 2025Pooled it
- Risk factors of hepatocellular carcinoma associated with nonalcoholic fatty liver disease: Systematic review and meta-analysis.Technology and health care : official journal of the European Society for Engineering and Medicine · 2024Pooled it
- EASL-EASD-EASO Clinical Practice Guidelines on the Management of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD).Obesity facts · 2024Guideline
- Type 2 diabetes, hepatic decompensation, and hepatocellular carcinoma in patients with non-alcoholic fatty liver disease: an individual participant-level data meta-analysis.The lancet. Gastroenterology & hepatology · 2023Pooled it
- Sex and regional disparities in incidence of hepatocellular carcinoma in autoimmune hepatitis: a systematic review and meta-analysis.Hepatology international · 2021Pooled it
- Association of metabolic traits with occurrence of nonalcoholic fatty liver disease-related hepatocellular carcinoma: A systematic review and meta-analysis of longitudinal cohort studies.Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology AssociationPooled it
- Semaglutide 2·4 mg once weekly in patients with non-alcoholic steatohepatitis-related cirrhosis: a randomised, placebo-controlled phase 2 trial.The lancet. Gastroenterology & hepatology · 2023Trial
- Diabetes and cancer: glucose control impact on survival and tumor outcomes.Reviews in endocrine & metabolic disorders · 2026Review
- Impact of cardiometabolic criteria on the pathogenesis of MASLD and diagnostic performance of non-invasive tests.Journal of gastroenterology · 2026Article
- [Detection and differentiation of atypical hepatocellular carcinomas].Radiologie (Heidelberg, Germany) · 2026Article
- Efficacy and safety of GLP-1 receptor agonists in MASH with fibrosis: A systematic review and meta-analysis.JHEP reports : innovation in hepatology · 2026Article
- Liver Stiffness Measurement and All-Cause Mortality in Individuals With Diabetes.JAMA network open · 2026Article
- Development and validation of machine learning models for diagnosing hepatocellular carcinoma risk and survival in patients with diabetic cirrhosis.Scientific reports · 2026Article
- Bibliometric Analysis of Emerging Trends and Hotspots in the Links between Nonalcoholic Steatohepatitis and Diabetes Mellitus from 2004 to 2023.Endocrine, metabolic & immune disorders drug targets · 2026Review
- Fatty Liver Index Dynamics as a Predictor of Hepatocellular Carcinoma in Patients with Type 2 Diabetes Mellitus and Non-Cirrhotic Livers.Endocrinology and metabolism (Seoul, Korea) · 2025Article
- Rewriting the MASLD-associated hepatocellular carcinoma script: Targeting epigenetics and metabolism.International journal of cancer · 2025Review
49 more citing papers are in PubMed but not listed here.
Corrections and comments
Authors and funding
7 authors at 4 institutions in 1 country.
Funding
Abstract
Diabetes increases the risk of liver disease progression and cirrhosis development in patients with nonalcoholic steatohepatitis (NASH). The association between diabetes and the risk of hepatocellular carcinoma (HCC) in NASH patients with cirrhosis is not well quantified. All patients with the diagnosis of NASH cirrhosis seen at Mayo Clinic Rochester between January 2006 and December 2015 were identified. All adult liver transplant registrants with NASH between 2004 and 2017 were identified using the United Network for Organ Sharing (UNOS)/Organ Procurement and Transplantation registry for external validation. Cox proportional hazard analysis was performed to investigate the association between diabetes and HCC risk. Among 354 Mayo Clinic patients with NASH cirrhosis, 253 (71%) had diabetes and 145 (41%) were male. Mean age at cirrhosis evaluation was 62. During a median follow-up of 47 months, 30 patients developed HCC. Diabetes was associated with an increased risk of developing HCC in univariate (hazard ratio [HR] = 3.6; 95% confidence interval [CI] = 1.1-11.9; P = 0.04) and multivariable analysis (HR = 4.2; 95% CI = 1.2-14.2; P = 0.02). In addition, age (per decade, HR = 1.8; 95% CI = 1.2-2.6; P < 0.01) and low serum albumin (HR = 2.1; 95% CI = 1.5-2.9; P < 0.01) were significantly associated with an increased risk of developing HCC in multivariable analysis. Other metabolic risk factors, including body mass index, hyperlipidemia, and hypertension, were not associated with HCC risk. Among UNOS NASH registrants (N = 6,630), 58% had diabetes. Diabetes was associated with an increased risk of developing HCC in univariate (HR = 1.4; 95% CI = 1.1-1.8; P < 0.01) and multivariable (HR = 1.3; 95% CI = 1.0-1.7; P = 0.03) analysis. Conclusion: Diabetes is associated with an increased risk of HCC in patients with NASH cirrhosis.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.