ArticleBMC gastroenterology2021
Hepatocellular carcinoma in nonalcoholic fatty liver disease with or without cirrhosis: a population-based study.
Article in BMC gastroenterology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 3 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
41 citing papers in PubMed, 3 syntheses or guidelines pooled it, 66 citations in OpenAlex.
- Statin Therapy Independently Reduces Mortality and Liver Complications in Patients With Cirrhosis: An Updated Systematic Review and Meta-Analysis.Alimentary pharmacology & therapeutics · 2026Pooled it
- Statin use and risk of HCC in patients with MASLD and T2DM: an umbrella review and meta-analysis.BMC cancer · 2025 · on this mapPooled it
- Global epidemiology of type 2 diabetes in patients with NAFLD or MAFLD: a systematic review and meta-analysis.BMC medicine · 2024Pooled it
- Article
- Cirrhosis severity modulates proteomic and immune landscapes in hepatocellular carcinoma.Npj gut and liver · 2026Article
- Hepatocellular carcinoma in patients without cirrhosis.World journal of gastroenterology · 2025Review
- Unveiling the role of IL7R in metabolism-associated fatty liver disease leading to hepatocellular carcinoma through transcriptomic and machine learning approaches.Discover oncology · 2025Article
- Hepatic IR and IGF1R signaling govern distinct metabolic and carcinogenic processes upon PTEN deficiency in the liver.JHEP reports : innovation in hepatology · 2025Article
- Risk-stratified hepatocellular carcinoma surveillance in non-cirrhotic patients with MASLD.Gastroenterology report · 2025Review
- Aberrant fragmentomic features of circulating cell-free mitochondrial DNA enable early detection and prognosis prediction of hepatocellular carcinoma.Clinical and molecular hepatology · 2025Article
- Article
- Evolving epidemiology of non-alcoholic fatty liver disease in South Korea: incidence, prevalence, progression, and healthcare implications from 2010 to 2022.The Korean journal of internal medicine · 2024Article
- Review
- Hydroxytyrosol Linoleoyl Ether Ameliorates Metabolic-Associated Fatty Liver Disease Symptoms in Obese Zucker Rats.ACS pharmacology & translational science · 2024Article
- Hepatitis-C-Related Hepatocellular Carcinoma, Still a Relevant Etiology beyond a Hepatitis C Infection Cure.Cancers · 2024Article
- GDF11: An emerging therapeutic target for liver diseases and fibrosis.Journal of cellular and molecular medicine · 2024Review
- Article
- Metabolic Dysfunction-Associated Steatohepatitis and Progression to Hepatocellular Carcinoma: A Literature Review.Cancers · 2024Review
- The Growing Landscape of NAFLD-Associated Hepatocellular Carcinoma and Its Impact in Surveillance.GE Portuguese journal of gastroenterology · 2024Review
- Air pollutants and primary liver cancer mortality: a cohort study in crop-burning activities and forest fires area.Frontiers in public health · 2024Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundThere are limited data regarding the factors associated with hepatocellular carcinoma (HCC) in non-alcoholic fatty liver disease (NAFLD) patients without cirrhosis. We sought to determine the prevalence and factors associated with HCC in NAFLD patients with or without cirrhosis.
methodsAdults with NAFLD (June 2015 to May 2020) were identified using the electronic health record database (Explorys Inc, Cleveland, OH) from 26 major integrated US healthcare systems. The prevalence of HCC was calculated. Multivariable analyses adjusting for covariates were performed to evaluate the associated risk factors and the presence of HCC.
resultsA total of 392,800 NAFLD patients were identified. Among 1110 patients with HCC, 170 (15.3%) had no cirrhosis. The prevalence of HCC in non-cirrhotic and cirrhotic NAFLD patients was 4.6/10,000 persons (95% CI 3.9-5.3), and 374.4/10,000 persons (95% CI 350.9-398.8), respectively. Age > 65 years (adjusted OR; 3.37, 95% CI 2.47-4.59), ever had elevated alanine aminotransferase (2.69; 2.14-3.37), male gender (2.57; 1.88-3.49), smoker (1.75; 1.23-2.49), and diabetes (1.56; 1.15-2.11) were associated with HCC in non-cirrhotic NAFLD (all P < 0.05). The prevalence of HCC in the non-cirrhotic with all five risk factors was 45.5/10,000 persons (95% CI 17.4-73.6). The factors associated with HCC in cirrhotic NAFLD included clinical decompensation, age > 65 years, male gender, Hispanic race, elevated alanine aminotransferase, diabetes and smoker (all P < 0.05).
conclusionsThese data identified the major risk factors for the development of HCC in NAFLD patients. In the non-cirrhotics, older male patients with smoking history, diabetes and an elevated alanine aminotransferase had highest risk and may need increased judicious monitoring.
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