Association of MASLD with the risk of extrahepatic cancers: A systematic review and meta-analysis of 18 cohort studies

IF 4.4 3区医学 Q1 MEDICINE, GENERAL & INTERNAL European Journal of Clinical Investigation Pub Date : 2024-06-28 DOI:10.1111/eci.14276

Ben-Gang Zhou, Xin Jiang, Qiang She, Yan-Bing Ding

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Abstract

Background

Numerous recent studies have explored the association between metabolic dysfunction-associated steatotic liver disease (MASLD) and the risk of various extrahepatic cancers. However, the conclusions were inconclusive. The aim of this study was to clarify this relationship by conducting a robust meta-analysis.

Methods

Systematic searches were conducted on PubMed, Embase and Web of Science databases to identify relevant cohort studies published prior to February 2024. Hazard ratios (HRs) and their corresponding 95% confidence intervals (95% CIs) were combined using a random-effects model in this meta-analysis.

Results

Eighteen cohort studies (approximately 16.7 million participants) were finally included in this meta-analysis. MASLD was linked to a higher risk of extrahepatic cancers, such as gastric (n = 10, HR = 1.47, 95% CI: 1.07–2.01), colorectal (n = 13, HR = 1.33, 95% CI: 1.16–1.53), pancreatic (n = 8, HR = 1.41, 95% CI: 1.11–1.79), biliary tract (n = 5, HR = 1.27, 95% CI: 1.18–1.37), thyroid (n = 6, HR = 1.46, 95% CI: 1.02–2.09), urinary system (n = 10, HR = 1.45, 95% CI: 1.25–1.69), breast (n = 11, HR = 1.17, 95% CI: 1.08–1.26) and female genital organ cancers (n = 10, HR = 1.36, 95% CI: 1.11–1.66). However, there was no statistically significant association between MASLD and the risk of head and neck (n = 6, HR = 1.03, 95% CI: 99–1.07), oesophageal (n = 9, HR = 1.26, 95% CI: 0.86–1.86), lung (n = 9, HR = 1.01, 95% CI: 0.92–1.10), prostate (n = 9, HR = 1.06, 95% CI: 0.94–1.19) or small intestine cancer (n = 2, HR = 1.75, 95% CI: 1.00–3.06).

Conclusions

This latest large-scale meta-analysis indicated that MASLD was associated with an increased risk of various extrahepatic cancers, such as gastric, colorectal, pancreatic, biliary duct, thyroid, urinary system, breast, skin and female genital cancers. Further research is needed to investigate the mechanisms underlying these associations.

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MASLD与肝外癌症风险的关系：18项队列研究的系统回顾和荟萃分析。

背景：最近有许多研究探讨了代谢功能障碍相关性脂肪性肝病（MASLD）与各种肝外癌症风险之间的关系。然而，结论并不明确。本研究旨在通过进行可靠的荟萃分析来澄清这种关系：在 PubMed、Embase 和 Web of Science 数据库中进行系统检索，以确定 2024 年 2 月之前发表的相关队列研究。荟萃分析中使用随机效应模型合并了危险比（HRs）及其相应的 95% 置信区间（95% CIs）：本次荟萃分析最终纳入了18项队列研究（约1670万参与者）。MASLD与较高的肝外癌症风险有关，如胃癌（n = 10，HR = 1.47，95% CI：1.07-2.01）、结直肠癌（n = 13，HR = 1.33，95% CI：1.16-1.53）、胰腺癌（n = 8，HR = 1.41，95% CI：1.11-1.79）、胆道癌（n = 5，HR = 1.27，95% CI：1.18-1.37）、甲状腺癌（n = 6，HR = 1.46，95% CI：1.02-2.09）、泌尿系统癌症（n = 10，HR = 1.45，95% CI：1.25-1.69）、乳腺癌（n = 11，HR = 1.17，95% CI：1.08-1.26）和女性生殖器官癌症（n = 10，HR = 1.36，95% CI：1.11-1.66）。然而，MASLD与头颈部癌症（n = 6，HR = 1.03，95% CI：99-1.07）、食道癌（n = 9，HR = 1.26，95% CI：0.86-1.86）、肺癌（n = 9，HR = 1.01，95% CI：0.92-1.10）、前列腺癌（n = 9，HR = 1.06，95% CI：0.94-1.19）或小肠癌（n = 2，HR = 1.75，95% CI：1.00-3.06）：这项最新的大规模荟萃分析表明，MASLD 与罹患胃癌、结直肠癌、胰腺癌、胆管癌、甲状腺癌、泌尿系统癌、乳腺癌、皮肤癌和女性生殖器癌等各种肝外癌症的风险增加有关。需要进一步研究这些关联的机制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Clinical Investigation 医学-医学：内科

CiteScore

9.50

自引率

3.60%

发文量

192

审稿时长

1 months

期刊介绍： EJCI considers any original contribution from the most sophisticated basic molecular sciences to applied clinical and translational research and evidence-based medicine across a broad range of subspecialties. The EJCI publishes reports of high-quality research that pertain to the genetic, molecular, cellular, or physiological basis of human biology and disease, as well as research that addresses prevalence, diagnosis, course, treatment, and prevention of disease. We are primarily interested in studies directly pertinent to humans, but submission of robust in vitro and animal work is also encouraged. Interdisciplinary work and research using innovative methods and combinations of laboratory, clinical, and epidemiological methodologies and techniques is of great interest to the journal. Several categories of manuscripts (for detailed description see below) are considered: editorials, original articles (also including randomized clinical trials, systematic reviews and meta-analyses), reviews (narrative reviews), opinion articles (including debates, perspectives and commentaries); and letters to the Editor.