Association between metabolic risk factors and hepatocellular carcinoma: a systematic review and meta-analysis of cohort studies - Report - MDSpire

Association between metabolic risk factors and hepatocellular carcinoma: a systematic review and meta-analysis of cohort studies

  • By

  • Xiaoli Yang

  • Peng Fu

  • Hui Liu

  • July 17, 2026

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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 FactorHazard Ratio (HR)95% Confidence Interval (95% CI)
Metabolic Syndrome1.801.44–2.25
Diabetes Mellitus2.011.79–2.27
BMI ≥ 24 kg/m²1.471.35–1.61
Waist Circumference1.391.26–1.55
Waist-to-Hip Ratio1.331.16–1.52
Waist-to-Height Ratio2.231.42–3.51
Reduced Triglycerides1.361.09–1.69
Hypertension1.431.13–1.81

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.

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  5. AGA Clinical Practice Update on Risk Stratification and Emerging Surveillance Strategies for Hepatocellular Carcinoma: Expert Review
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  7. EASL-EASD-EASO Clinical Practice Guidelines on the Management of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) - PMC
  8. Clinical care pathway for the risk stratification and management of patients with MASLD  – American Gastroenterological Association
  9. Critical Update: AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma - PubMed
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  15. Risk factors for hepatocellular carcinoma: an umbrella review of systematic review and meta-analysis - PMC
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  17. Clinical Gastroenterology and Hepatology 2025;-:-–-
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