Nor Asiah Muhamad, Nur Hasnah Maamor, Fatin Norhasny Leman, Zuraifah Asrah Mohamad, Sophia Karen Bakon, Mohd Hatta Abdul Mutalip, Izzah Athirah Rosli, Tahir Aris, Nai Ming Lai, Muhammad Radzi Abu Hassan
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引用次数: 1
Abstract
Background: Nonalcoholic fatty liver disease (NAFLD) is one of the common causes of chronic liver disease globally. Obesity, metabolic diseases, and exposure to some environmental agents contribute to NAFLD. NAFLD is commonly considered a precursor for some types of cancers. Since the leading causes of death in people with NAFLD are cardiovascular disease and extrahepatic cancers, it is important to understand the mechanisms of the progression of NAFLD to control its progression and identify its association with extrahepatic cancers. Thus, this review aims to estimate the global prevalence of NAFLD in association with the risk of extrahepatic cancers.
Objective: We aimed to determine the prevalence of various cancers in NAFLD patients and the association between NAFLD and cancer.
Methods: We searched PubMed, ProQuest, Scopus, and Web of Science from database inception to March 2022 to identify eligible studies reporting the prevalence of NAFLD and the risk of incident cancers among adult individuals (aged ≥18 years). Data from selected studies were extracted, and meta-analysis was performed using random effects models to obtain the pooled prevalence with the 95% CI. The quality of the evidence was assessed with the Newcastle-Ottawa Scale.
Results: We identified 11 studies that met our inclusion criteria, involving 222,523 adults and 3 types of cancer: hepatocellular carcinoma (HCC), breast cancer, and other types of extrahepatic cancer. The overall pooled prevalence of NAFLD and cancer was 26% (95% CI 16%-35%), while 25% of people had NAFLD and HCC (95% CI 7%-42%). NAFLD and breast cancer had the highest prevalence out of the 3 forms of cancer at 30% (95% CI 14%-45%), while the pooled prevalence for NAFLD and other cancers was 21% (95% CI 12%-31%).
Conclusions: The review suggests that people with NAFLD may be at an increased risk of cancer that might not affect not only the liver but also other organs, such as the breast and bile duct. The findings serve as important evidence for policymakers to evaluate and recommend measures to reduce the prevalence of NAFLD through lifestyle and environmental preventive approaches.
背景:非酒精性脂肪性肝病(NAFLD)是全球慢性肝病的常见病因之一。肥胖、代谢性疾病和暴露于某些环境因素可导致NAFLD。NAFLD通常被认为是某些类型癌症的前兆。由于NAFLD患者死亡的主要原因是心血管疾病和肝外癌，因此了解NAFLD的进展机制以控制其进展并确定其与肝外癌的关系非常重要。因此，本综述旨在评估NAFLD的全球患病率与肝外癌风险的关系。目的:我们旨在确定NAFLD患者中各种癌症的患病率以及NAFLD与癌症之间的关系。方法:我们检索PubMed、ProQuest、Scopus和Web of Science从数据库建立到2022年3月，以确定符合条件的研究报告NAFLD的患病率和成人(年龄≥18岁)发生癌症的风险。从选定的研究中提取数据，并使用随机效应模型进行meta分析，以获得95% CI的合并患病率。用纽卡斯尔-渥太华量表评估证据的质量。结果:我们确定了11项符合纳入标准的研究，涉及222,523名成年人和3种类型的癌症:肝细胞癌(HCC)、乳腺癌和其他类型的肝外癌。NAFLD和癌症的总患病率为26% (95% CI为16%-35%)，而25%的人患有NAFLD和HCC (95% CI为7%-42%)。在3种癌症中，NAFLD和乳腺癌的患病率最高，为30% (95% CI 14%-45%)，而NAFLD和其他癌症的总患病率为21% (95% CI 12%-31%)。结论:该综述表明，NAFLD患者患癌症的风险可能会增加，这些癌症不仅会影响肝脏，还会影响其他器官，如乳房和胆管。这些发现为决策者评估和推荐通过生活方式和环境预防方法降低NAFLD患病率的措施提供了重要证据。试验注册:PROSPERO CRD42022321946;https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=321946。
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