Impact of metabolic dysfunction-associated steatotic liver disease on liver metastasis and survival in pancreatic cancer

Table 1 Baseline characteristics of the participants (n = 2123), n (%)

Characteristics	Total (n = 2123)	With liver metastasis (n = 540)	Without liver metastasis (n = 1584)	P value
Patient
Age (years), median IQR	66 (58-73)	65 (58.0-72.0)	66 (58.0-73.0)	0.057
Male	1118 (52.6)	298 (55.2)	820 (51.8)	0.174
Body mass index (kg/m2), median IQR	22.7 (20.8-24.9)	22.8 (20.7-25.1)	22.7 (20.8-24.8)	0.571
Diabetes mellitus	1042 (49.1)	245 (45.4)	797 (50.3)	0.046
Hypertension	919 (43.3)	239 (44.3)	680 (43.0)	0.598
Cirrhosis	4 (0.2)	1 (0.2)	3 (0.2)	0.984
HSI, median IQR	33.9 (30.6-37.5)	34.0 (30.7-37.8)	33.8 (30.6-37.4)	0.585
HSI > 30	1683 (79.3)	426 (78.9)	1257 (79.4)	0.798
HSI > 36	729 (34.3)	192 (35.6)	537 (33.9)	0.490
TG (mg/dL), median IQR	102 (75-138)	100 (79-143)	103 (75-136)	0.929
HDL (mg/dL), median IQR	42 (32-50)	40 (32-47)	42 (32-52)	0.043
LDL (mg/dL), median IQR	86 (64-116)	84 (62-105)	87 (65-118)	0.334
Total bilirubin (mg/dL), median IQR	0.7 (0.5-1.4)	0.7 (0.5-1.3)	0.7 (0.5-1.4)	0.461
Tumor
Location				< 0.001
Head	904 (42.6)	181 (33.5)	723 (45.7)
Body	474 (22.3)	114 (21.1)	360 (22.8)
Tail	375 (17.7)	139 (25.7)	236 (14.9)
Mixed	369 (17.4)	106 (19.7)	263 (16.6)
Size (mm), median IQR	36.0 (28.0-48.0)	41 (32-55)	35 (26-45)	< 0.001
CA19-9 (U/mL), median IQR	259.6 (31.4-1647.0)	975.0 (45.0-6092.3)	206.2 (30.0-1046.3)	< 0.001

IQR: Interquartile range; HSI: Hepatic steatosis index; TG: Triglyceride; HDL: High-density lipoprotein; LDL: Low-density lipoprotein; CA: Carbohydrate antigen.

Table 2 Risk factors for liver metastasis in the study cohort

Variables	Univariate			Multivariate
	OR	95%CI	P value	OR	95%CI	P value
Age (years)	0.991	0.982-1.000	0.053
Male	1.146	0.942-1.394	0.174
Diabetes mellitus	0.819	0.673-0.996	0.046	0.421	0.233-0.758	0.004
Hypertension	1.054	0.866-1.284	0.598
Cirrhosis	0.748	0.368-1.522	0.424
Body mass index (kg/m2)	1.014	0.983-1.046	0.373
Tumor size	1.026	1.018-1.034	< 0.001	1.037	1.021-1.054	< 0.001
HSI	1.009	0.995-1.023	0.217
HSI > 30	0.969	0.762-1.232	0.798
HSI > 36	1.075	0.876-1.319	0.490
TG (mg/dL)	1.000	0.998-1.003	0.852
HDL (mg/dL)	0.986	0.974-0.999	0.029	0.983	0.966-1.001	0.059
LDL (mg/dL)	0.996	0.991-1.001	0.165
CA19-9 > 260 (U/mL)	1.935	1.582-2.367	< 0.001	1.747	1.035-2.948	0.037

OR: Odds ratio; CI: Confidence interval; HSI: Hepatic steatosis index; TG: Triglyceride; HDL: High-density lipoprotein; LDL: Low-density lipoprotein; CA: Carbohydrate antigen.

Table 3 Risk factors for liver metastasis in patients without liver metastasis at the primary diagnosis of pancreatic cancer

Variables	Univariate			Multivariate
	HR	95%CI	P value	HR	95%CI	P value
Age (years)	0.987	0.979-0.995	0.002	0.985	0.974-0.997	0.016
Male	0.882	0.740-1.051	0.159
Diabetes mellitus	0.853	0.714-1.019	0.080
Hypertension	1.080	0.906-1.287	0.389
Cirrhosis	1.084	0.152-7.711	0.936
Body mass index (kg/m2)	1.000	0.971-1.029	0.977
Tumor size	1.013	1.006-1.020	< 0.001	1.008	1.001-1.016	0.031
HSI	1.004	0.990-1.019	0.558
HSI > 30	0.921	0.741-1.144	0.457
HSI > 36	0.964	0.800-1.161	0.700
TG (mg/dL)	1.000	0.999-1.002	0.733
HDL (mg/dL)	0.994	0.985-1.003	0.164
LDL (mg/dL)	1.000	0.997-1.003	0.943
CA19-9 > 260 (U/mL)	1.662	1.393-1.984	< 0.001	1.662	1.279-2.160	< 0.001

HR: Hazard ratio; CI: Confidence interval; HSI: Hepatic steatosis index; TG: Triglyceride; HDL: High-density lipoprotein; LDL: Low-density lipoprotein; CA: Carbohydrate antigen.

Table 4 Risk factors for mortality in all patients

Variables	Univariate			Multivariate
	HR	95%CI	P value	HR	95%CI	P value
Age (years)	1.019	1.012-1.026	< 0.001	1.014	0.997-1.031	0.097
Male	1.079	0.941-1.238	0.276
Diabetes mellitus	0.652	0.567-0.750	< 0.001	0.525	0.358-0.769	0.001
Hypertension	1.038	0.905-1.191	0.593
Cirrhosis	1.497	0.374-5.996	0.569
Body mass index (kg/m2)	0.980	0.958-1.002	0.078
Tumor size	1.016	1.011-1.021	< 0.001	1.025	1.014-1.035	< 0.001
HSI	0.997	0.985-1.009	0.591
HSI > 30	0.807	0.685-0.952	0.011	1.007	0.650-1.561	0.975
HSI > 36	0.945	0.817-1.094	0.451
TG (mg/dL)	0.998	0.996-1.000	0.027	0.997	0.994-1.000	0.026
HDL (mg/dL)	0.992	0.984-1.000	0.040	0.988	0.977-0.998	0.023
LDL (mg/dL)	1.000	0.997-1.002	0.966
CA19-9 > 260 (U/mL)	1.825	1.587-2.099	< 0.001	1.443	1.057-1.970	0.021

HR: Hazard ratio; CI: Confidence interval; HSI: Hepatic steatosis index; TG: Triglyceride; HDL: High-density lipoprotein; LDL: Low-density lipoprotein; CA: Carbohydrate antigen.

Table 5 Risk factors for mortality in patients with liver metastasis

Variables	Univariate			Multivariate
	HR	95%CI	P value	HR	95%CI	P value
Age (years)	1.019	1.009-1.028	< 0.001	1.021	1.001-1.041	0.043
Male	0.975	0.816-1.165	0.782
Diabetes mellitus	0.682	0.569-0.819	< 0.001	0.648	0.423-0.992	0.046
Hypertension	0.989	0.828-1.182	0.904
Cirrhosis	4.304	1.071-17.290	0.040
Body mass index (kg/m2)	0.993	0.964-1.023	0.639
Tumor size	1.013	1.006-1.020	< 0.001	1.017	1.005-1.029	0.007
HSI	1.000	0.986-1.016	0.953
HSI > 30	0.820	0.661-1.018	0.072
HSI > 36	0.993	0.822-1.199	0.942
TG (mg/dL)	0.997	0.995-1.000	0.022	0.997	0.994-1.000	0.031
HDL (mg/dL)	0.998	0.987-1.008	0.667
LDL (mg/dL)	0.997	0.992-1.002	0.199
CA19-9 > 260 (U/mL)	1.690	1.407-2.029	< 0.001	1.312	0.892-1.928	0.168

HR: Hazard ratio; CI: Confidence interval; HSI: Hepatic steatosis index; TG: Triglyceride; HDL: High-density lipoprotein; LDL: Low-density lipoprotein; CA: Carbohydrate antigen.