Association between metabolic risk factors and hepatocellular carcinoma: a systematic review and meta-analysis of cohort studies
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By
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Xiaoli Yang
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Peng Fu
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Hui Liu
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July 17, 2026
Clinical Report: Linking Metabolic Risk Factors to Hepatocellular Carcinoma
Overview
This systematic review and meta-analysis identifies metabolic risk factors associated with hepatocellular carcinoma (HCC). Key findings include metabolic syndrome, diabetes mellitus, and various obesity metrics linked to HCC risk.
Background
Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality globally, with metabolic disorders recognized as risk factors. Understanding the relationship between metabolic dysregulation and HCC is crucial for screening and prevention strategies.
Data Highlights
| Metabolic Risk Factor | Hazard Ratio (HR) | 95% Confidence Interval (95% CI) |
|---|---|---|
| Metabolic Syndrome | 1.80 | 1.44–2.25 |
| Diabetes Mellitus | 2.01 | 1.79–2.27 |
| BMI ≥ 24 kg/m² | 1.47 | 1.35–1.61 |
| Waist Circumference | 1.39 | 1.26–1.55 |
| Waist-to-Hip Ratio | 1.33 | 1.16–1.52 |
| Waist-to-Height Ratio | 2.23 | 1.42–3.51 |
| Reduced Triglycerides | 1.36 | 1.09–1.69 |
| Hypertension | 1.43 | 1.13–1.81 |
Key Findings
- Metabolic syndrome is associated with an increased risk of HCC (HR = 1.80).
- Diabetes mellitus significantly elevates HCC risk (HR = 2.01).
- Body mass index (BMI) ≥ 24 kg/m² correlates with a higher risk of HCC (HR = 1.47).
- Waist-to-height ratio shows a strong association with HCC risk (HR = 2.23).
- Reduced triglyceride levels are linked to increased HCC risk (HR = 1.36).
Clinical Implications
Identifying and managing metabolic risk factors may be essential for HCC prevention strategies.
Conclusion
The findings indicate the role of metabolic risk factors in the development of HCC.
Related Resources & Content
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- Frontiers in Medicine, 2026 -- Serum M2BPGi as a predictor of hepatocellular carcinoma development in chronic hepatitis B and C: a systematic review and meta-analysis
- the new gastroenterologist, 2026 -- MASLD fibrosis significantly drives HCC risk, study finds
- Frontiers in Endocrinology — Association of metabolic dysfunction-associated steatotic liver disease trajectories with incident liver cancer: a UK Biobank cohort study
- AGA Clinical Practice Update on Risk Stratification and Emerging Surveillance Strategies for Hepatocellular Carcinoma: Expert Review
- Trial design and end points in hepatocellular carcinoma: an EASL–AASLD–ILCA consensus statement
- EASL-EASD-EASO Clinical Practice Guidelines on the Management of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) - PMC
- Clinical care pathway for the risk stratification and management of patients with MASLD – American Gastroenterological Association
- Critical Update: AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma - PubMed
- Management of Hepatocellular Carcinoma | AASLD
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- Association of overweight/obesity and digestive system cancers: A meta-analysis and trial sequential analysis of prospective cohort studies | PLOS One
- Body Mass Index and Hepatocellular Carcinoma Incidence: A Systematic Review and Dose–Response Meta-Analysis of Prospective Cohort Studies by Yan-Yun Lu, Claire Shin-Yeh Wu, Jin-Hua Chen, Jie-Syuan Wu, Lee-Yuan Lin, Chun-Ying Wu, Tsai-Wei Huang :: SSRN
- Risk factors for hepatocellular carcinoma: an umbrella review of systematic review and meta-analysis - PMC
- Risk factors of hepatocellular carcinoma associated with nonalcoholic fatty liver disease: Systematic review and meta-analysis - PubMed
- Clinical Gastroenterology and Hepatology 2025;-:-–-
- The versatile interplay between steatotic liver disease and liver cancer | Nature Reviews Cancer
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