ArticleJournal of clinical medicine2023
Smoking Increases the Risk of Hepatocellular Carcinoma and Cardiovascular Disease in Patients with Metabolic-Associated Fatty Liver Disease.
Article in Journal of clinical medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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The trial behind it
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
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- EASL-EASD-EASO Clinical Practice Guidelines on the Management of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD).Obesity facts · 2024Guideline
- The Malaysian Society of Gastroenterology and Hepatology Consensus Statements on Prevention and Early Detection of Hepatocellular Carcinoma in Malaysia.Journal of gastroenterology and hepatology · 2026Review
- MASLD and Cardiovascular Risk: Mechanisms and Implications for Clinical Practice.Current hypertension reports · 2026Review
- New oral anticoagulants and hepatocellular carcinoma among patients with HBV, HCV, and alcoholic liver diseases: a nationwide cohort study.Hepatology international · 2026Article
- The versatile interplay between steatotic liver disease and liver cancer.Nature reviews. Cancer · 2026Review
- Pathogenesis and intervention strategies for metabolic dysfunction-associated fatty liver disease from the perspective of the gut-microbiota-liver axis.Frontiers in immunology · 2026Review
- Divergent risk profiles for cause-specific mortality in MASLD and MetALD: a nationwide population-based study.Frontiers in medicine · 2026Article
- Smoking and liver diseases: an updated review of pathogenesis, progression, and therapeutic implications.Clinical and experimental medicine · 2025Review
- Diet and Lifestyle Interventions in Metabolic Dysfunction-Associated Fatty Liver Disease: A Comprehensive Review.International journal of molecular sciences · 2025Review
- Prevalence and Trends in Active Smoking Among Adults Living with HCV in the U.S. over the Last Decade: A Population-Level Analysis.Journal of clinical medicine · 2025Article
- Article
- Addressing the essentials of the recent guidelines for managing patients with metabolic dysfunction-associated steatotic liver disease.Hormones (Athens, Greece) · 2025Review
- Review
- Article
- Observational
- A comprehensive analysis of the impact of smoking on adverse clinical outcomes of steatotic liver diseases.Therapeutic advances in gastroenterology · 2025Article
- Beyond the Liver: A Comprehensive Review of Strategies to Prevent Hepatocellular Carcinoma.Journal of clinical medicine · 2024Review
- The Role of Dietary Ingredients and Herbs in the Prevention of Non-Communicable Chronic Liver Disease.Nutrients · 2024Review
- Heavy smoking increases early mortality risk in patients with hepatocellular carcinoma after curative treatment.Journal of liver cancer · 2024Article
- Impacts of smoking on alcoholic liver disease: a nationwide cohort study.Frontiers in public health · 2024Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
The association of smoking with hepatocellular carcinoma (HCC) or cardiovascular disease (CVD) has been reported, but the study of its relationship with metabolic-associated fatty liver disease (MAFLD) is limited. We aimed to investigate the effect of smoking on the incidence of HCC or CVD in MAFLD patients. Using the Korean nationwide health screening database, we analyzed subjects between 2001 and 2015. A total of 283,088 subjects including 110,863 MAFLD patients and 172,225 controls were analyzed. Smoking status was divided by non-smoker, ex-smoker, or current smoker. In the follow-up period, a total of 2903 (1.0%) subjects developed HCC, and the MAFLD group (1723, 1.6%) had a significantly higher incidence than the control group (1180, 0.7%). In the MAFLD group, current smokers showed significantly higher risk of HCC compared to non-smokers (adjusted HR 1.24, 95% CI 1.08-1.41), whereas the control group did not (adjusted HR 1.07, 95% CI 0.89-1.30). A total of 18,984 (6.7%) patients developed CVD, and the incidence was significantly higher in the MAFLD group (8688, 7.8%) than in the control group (10,296, 6.0%), similar to HCC. The risk of CVD in current smokers increased by 22% compared to non-smokers in the MAFLD group (adjusted HR 1.22, 95% CI 1.15-1.30) and by 21% (adjusted HR 1.21, 95% CI 1.13-1.29) in the control group. Based on sex stratification, men showed increased incidence of both HCC and CVD by smoking, whereas women had only increased risk of CVD. Smoking significantly increases the incidence of HCC and CVD in MAFLD patients; thus, it is highly recommended to quit smoking completely in the population with MAFLD.
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