Nonalcoholic Fatty liver disease, diabetes, obesity, and hepatocellular carcinoma

Clin Liver Dis. 2015 May;19(2):361-79. doi: 10.1016/j.cld.2015.01.012. Epub 2015 Mar 12.

Abstract

Diabetes and obesity are associated with nonalcoholic fatty liver disease (NAFLD) and an increased incidence of hepatocellular carcinoma (HCC). NAFLD is the commonest cause of chronic liver disease. HCC can develop in NAFLD patients even without cirrhosis, suggesting an association between the metabolic process and HCC and raising a concern that many cancers could be missed given high NAFLD prevalence and screening limitations. The increasing prevalence of these conditions and lack of effective treatments necessitate a better understanding of their connection. This article defines the known interrelationships and common pathways between NAFLD, diabetes, obesity and HCC and possible chemoprevention strategies.

Keywords: Chemoprevention; Cirrhosis; Diabetes; Hepatocellular carcinoma; Insulin resistance; Nonalcoholic steatohepatitis; Noncirrhotic; Obesity.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Carcinoma, Hepatocellular / epidemiology*
  • Carcinoma, Hepatocellular / prevention & control
  • Chemoprevention
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / physiopathology*
  • Endoplasmic Reticulum Stress
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Hypoglycemic Agents / therapeutic use
  • Incidence
  • Inflammation / epidemiology
  • Insulin Resistance
  • JNK Mitogen-Activated Protein Kinases / metabolism
  • Leptin / metabolism
  • Liver Neoplasms / epidemiology*
  • Liver Neoplasms / prevention & control
  • Metformin / therapeutic use
  • Non-alcoholic Fatty Liver Disease / epidemiology
  • Non-alcoholic Fatty Liver Disease / physiopathology*
  • Obesity / epidemiology
  • Obesity / physiopathology*
  • Risk Factors
  • S-Adenosylmethionine / metabolism
  • Toll-Like Receptors / metabolism

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Hypoglycemic Agents
  • Leptin
  • Toll-Like Receptors
  • S-Adenosylmethionine
  • Metformin
  • JNK Mitogen-Activated Protein Kinases