Mild drinking habit is a risk factor for hepatocarcinogenesis in non-alcoholic fatty liver disease with advanced fibrosis

doi:10.3748/wjg.v24.i13.1440

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 24, Issue 13

This Article

Academic Content and Language Evaluation of This Article

CrossCheck and Google Search of This Article

Academic Rules and Norms of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Number of Hits and Downloads for This Article

Total Article Views (8967)

All Articles published online

The chart showing PDF series, WORD series, HTML series, Figures (1-3) series, Tables (1-5) series.

Item

Count

PDF

701

WORD

199

HTML

4788

Figures (1-3)

244

Tables (1-5)

200

Sum=6132

Publishing Process of This Article

The chart showing Browse series, Download series.

Item

Count

Browse

991

Download

1844

Sum=2835

Apr 7, 2018 (publication date) through Nov 27, 2024

Times Cited of This Article

Times Cited (59)

Journal Information of This Article

Publication Name

World Journal of Gastroenterology

ISSN

1007-9327

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

World J Gastroenterol. Apr 7, 2018; 24(13): 1440-1450
Published online Apr 7, 2018. doi: 10.3748/wjg.v24.i13.1440

Table 1 Comparison of clinicopathological features at the time of biopsy between mild drinking and non-drinking groups

	Mild drinking group (n = 93)	Non-drinking group (n = 208)	P value
Age (yr)	55 (19-77)	56 (10-84)	0.50
Male	52 (56)	84 (40)	0.01
Body mass index (kg/m²)	26.5 (18.3-40.0)	26.2 (17.8-41.0)	0.53
Co-existing disease
Diabetes mellitus	32 (34)	78 (38)	0.57
Hypertension	41 (44)	81 (39)	0.44
Hyperlipidemia	55 (59)	135 (66)	0.29
Laboratory data
Albumin (mg/dL)	4.5 (3.2-5.4)	4.5 (3.0-5.2)	0.48
Total bilirubin (mg/dL)	0.91 (0.40-2.20)	0.86 (0.38-2.64)	0.12
Aspartate aminotransferase (IU/L)	44 (20-175)	47 (13-263)	0.80
Alanine aminotransferase (IU/L)	68 (22-237)	67 (13-522)	0.74
Gamma-glutamyl transpeptidase (IU/L)	69 (19-400)	54 (7-544)	0.02
Cholinesterase (IU/L)	363 (171-586)	384 (189-591)	0.05
Fasting blood sugar (mg/dL)	106 (84-215)	108 (77-221)	0.63
HOMA-IR	3.4 (1.0-42.6)	3.3 (0.3-24.5)	0.58
HbA1c (%)	5.9 (5.1-9.8)	6.0 (4.9-12.3)	0.21
Total cholesterol (mg/dL)	205 (138-336)	208 (70-295)	0.68
Triglyceride (mg/dL)	115 (42-404)	133 (32-801)	0.14
Platelet (×10⁴/μL)	21.1 (5.3-45.4)	22.1 (7.2-40.7)	0.04
Hyaluronic acid (ng/mL)	43 (12-320)	49 (9-1611)	0.57
Type IV collagen 7s (ng/mL)	4.3 (2-20)	4.5 (2-11)	0.93
Alpha-fetoprotein (ng/mL)	3.3 (0.7-13.5)	3.0 (0.7-20.3)	0.41
Pathology
Steatosis			0.86
1	33 (36)	64 (31)
2	36 (39)	90 (43)
3	24 (26)	54 (26)
Lobular inflammation			0.14
0	5 (5)	8 (4)
1	47 (51)	83 (40)
2	37 (40)	95 (46)
3	4 (4)	22 (11)
Ballooning			0.82
0	18 (19)	41 (20)
1	50 (54)	118 (57)
2	25 (27)	49 (24)
NAFLD activity score			0.79
1	4 (4)	5 (2)
2	8 (9)	16 (8)
3	16 (17)	34 (16)
4	17 (18)	32 (15)
5	25 (27)	62 (30)
6	14 (15)	36 (17)
7	9 (10)	18 (9)
8	0 (0)	5 (2)
Fibrosis			0.39
0	17 (18)	40 (19)
1	39 (42)	93 (45)
2	10 (11)	25 (12)
3	18 (19)	42 (20)
4	9 (10)	8 (4)
Fibrosis 3-4 (Advanced fibrosis)	27 (29)	50 (24)	0.36
Fibrosis 4 (Cirrhosis)	9 (10)	8 (4)	0.04

Data are expressed as median (range) or n (%). HbA1c: Hemoglobin A1c; HOMA-IR: Homeostasis model assessment for insulin resistance.

Table 2 Comparison of clinicopathological features at the time of biopsy between hepatocellular carcinoma and non- hepatocellular carcinoma groups

	HCC group (n = 9)	Non-HCC group (n = 292)	P value
Age (yr)	65 (56-84)	55 (10-81)	< 0.01
Male	3 (33)	133 (46)	0.52
Body mass index (kg/m²)	26.0 (18.3-28.7)	26.2 (17.8-41.0)	0.23
Drinking habit	6 (67)	87 (30)	0.02
Co-existing disease
Diabetes mellitus	8 (89)	102 (35)	< 0.01
Hypertension	9 (100)	113 (39)	< 0.01
Hyperlipidemia	3 (33)	187 (65)	0.06
Laboratory data
Albumin (mg/dL)	4.0 (3.7-4.6)	4.5 (3.0-5.4)	< 0.01
Total bilirubin (mg/dL)	0.91 (0.44-1.61)	0.88 (0.38-2.64)	0.75
Aspartate aminotransferase (IU/L)	52 (32-95)	46 (13-263)	0.71
Alanine aminotransferase (IU/L)	53 (16-132)	68 (13-522)	0.11
Gamma-glutamyl transpeptidase (IU/L)	65 (28-192)	56 (7-544)	0.48
Cholinesterase (IU/L)	249 (190-434)	380 (171-591)	< 0.01
Fasting blood sugar (mg/dL)	133 (84-172)	106 (77-221)	0.13
HOMA-IR	5.8 (1.2-9.8)	3.3 (0.3-42.6)	0.18
HbA1c (%)	6.6 (6.0-7.0)	5.9 (4.9-12.3)	0.01
Total cholesterol (mg/dL)	176 (153-264)	208 (70-336)	0.02
Triglyceride (mg/dL)	85 (64-140)	130 (32-801)	0.02
Platelet (×10⁴/μL)	11.0 (6.4-18.6)	22.0 (5.3-45.4)	< 0.01
Hyaluronic acid (ng/mL)	42 (17-263)	42 (9-1180)	0.96
Type IV collagen 7s (ng/mL)	5.6 (4.7-8.4)	4.4 (2.0-20.0)	0.03
Alpha-fetoprotein (ng/mL)	6.0 (3.7-20.3)	3.0 (0.7-13.2)	< 0.01
Pathology
Steatosis			0.01
1	7 (78)	90 (31)
2	2 (22)	124 (43)
3	0 (0)	78 (27)
Lobular inflammation			0.21
0	0 (0)	13 (4)
1	2 (22)	128 (44)
2	7 (78)	125 (43)
3	0 (0)	26 (9)
Ballooning			0.76
0	1 (11)	58 (20)
1	6 (67)	162 (56)
2	2 (22)	72 (25)
NAFLD activity score			0.53
1	0 (0)	9 (3)
2	0 (0)	24 (8)
3	3 (33)	47 (16)
4	2 (22)	47 (16)
5	4 (44)	83 (28)
6	0 (0)	50 (17)
7	0 (0)	27 (9)
8	0 (0)	5 (2)
Fibrosis			< 0.01
0	0 (0)	57 (20)
1	0 (0)	132 (45)
2	0 (0)	35 (12)
3	4 (44)	56 (19)
4	5 (56)	12 (4)

Data are expressed as median (range) or n (%). HCC: Hepatocellular carcinoma; HOMA-IR: Homeostasis model assessment for insulin resistance; HbA1c: Hemoglobin A1c; NAFLD: Non-alcoholic fatty liver disease.

Table 3 Factors related to hepatic carcinogenesis by multivariate survival analysis using Cox's regression model for all patients

	P value	Relative risk	95%CI
Fibrosis	< 0.01	11.6	2.36-56.9
Diabetes mellitus	< 0.01	89.5	6.01-1331.2
Triglyceride	0.04	0.98	0.95-0.99
Drinking habit	0.07	4.43	0.88-22.4

Table 4 Comparison of clinicopathological features at the time of biopsy between hepatocellular carcinoma and non- hepatocellular carcinoma groups in non-alcoholic fatty liver disease patients with advanced fibrosis (F3-4)

	HCC group (n = 9)	Non-HCC group (n = 68)	P value
Age (yr)	65 (56-84)	64 (30-81)	0.32
Male	3 (33)	14 (21)	0.39
Body mass index (kg/m²)	26.0 (18.3-28.7)	27.7 (20.1-41.0)	0.05
Drinking habit	6 (67)	21 (31)	0.03
Co-existing disease
Diabetes mellitus	8 (89)	32 (47)	0.02
Hypertension	9 (100)	38 (56)	0.01
Hyperlipidemia	3 (33)	35 (52)	0.31
Laboratory data
Albumin (mg/dL)	4.0 (3.7-4.6)	4.3 (3.2-5.0)	0.07
Total bilirubin (mg/dL)	0.91 (0.44-1.61)	0.91 (0.48-2.15)	0.99
Aspartate aminotransferase (IU/L)	52 (32-95)	63 (20-200)	0.13
Alanine aminotransferase (IU/L)	53 (16-132)	71 (19-298)	0.09
Gamma-glutamyl transpeptidase (IU/L)	65 (28-192)	65 (25-205)	0.75
Cholinesterase (IU/L)	249 (190-434)	345 (171-467)	0.02
Fasting blood sugar (mg/dL)	133 (84-172)	110 (82-215)	0.30
HOMA-IR	5.8 (1.2-9.8)	4.3 (1.1-15.6)	0.54
HbA1c (%)	6.6 (6.0-7.0)	6.1 (5.0-10.9)	0.14
Total cholesterol (mg/dL)	176 (153-264)	201 (131-294)	0.10
Triglyceride (mg/dL)	85 (64-140)	119 (42-351)	0.03
Platelet (×10⁴/μL)	11.0 (6.4-18.6)	16.6 (5.3-32.6)	< 0.01
Hyaluronic acid (ng/mL)	42 (17-263)	59 (11-1180)	0.45
Type IV collagen 7s (ng/mL)	5.6 (4.7-8.4)	6.8 (3.5-20.0)	0.61
Alpha-fetoprotein (ng/mL)	6.0 (3.7-20.3)	5.0 (1.1-11.3)	0.04
Pathology
Steatosis			0.07
1	7 (78)	26 (38)
2	2 (22)	32 (47)
3	0 (0)	10 (15)
Lobular inflammation			0.45
0	0 (0)	1 (2)
1	2 (22)	17 (25)
2	7 (78)	37 (54)
3	0 (0)	13 (19)
Ballooning			0.76
0	1 (11)	1 (2)
1	6 (67)	34 (50)
2	2 (22)	33 (49)
NAFLD activity score			0.25
1	0 (0)	1 (2)
2	0 (0)	1 (2)
3	3 (33)	5 (7)
4	2 (22)	10 (15)
5	4 (44)	26 (38)
6	0 (0)	16 (24)
7	0 (0)	8 (12)
8	0 (0)	1 (2)

Table 5 Factors related to hepatic carcinogenesis by multivariate survival analysis using Cox's regression model for patients with advanced fibrosis (F3-4)

	P value	Relative risk	95%CI
Drinking habit	0.04	4.83	1.01-23.00
Alpha-fetoprotein	0.01	1.23	1.04-1.44
Diabetes mellitus	0.03	12.00	1.20-119.66

Citation: Kimura T, Tanaka N, Fujimori N, Sugiura A, Yamazaki T, Joshita S, Komatsu M, Umemura T, Matsumoto A, Tanaka E. Mild drinking habit is a risk factor for hepatocarcinogenesis in non-alcoholic fatty liver disease with advanced fibrosis. World J Gastroenterol 2018; 24(13): 1440-1450
URL: https://www.wjgnet.com/1007-9327/full/v24/i13/1440.htm
DOI: https://dx.doi.org/10.3748/wjg.v24.i13.1440