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Abstract：
OBJECTIVE: This study compared the prevalences of metabolic syndrome and of cardiac or kidney comorbidities among patients with hepatocellular carcinoma (HCC) associated with metabolic dysfunction-related fatty liver disease (MAFLD), chronic infection with hepatitis B or C virus (HBV or HCV), or the combination of MAFLD and chronic HBV infection.
METHODS: Medical records were retrospectively analyzed for patients with HCC who underwent hepatectomy between March 2013 and March 2023. Patients with HCC of different etiologies were compared in terms of their clinicodemographic characteristics and laboratory data before surgery.
RESULTS: Of the 2422 patients, 1,822 (75.2%) were chronically infected with HBV without MAFLD and HCV, 415 (17.2%) had concurrent MAFLD and chronic HBV infection but no HCV infection, 121 (5.0%) had MAFLD without hepatitis virus infection, and 64 (2.6%) were chronically infected with HCV in the presence or absence of MAFLD and HBV infection. Compared to patients chronically infected with HBV without MAFLD and HCV, those with MAFLD but no hepatitis virus infection showed significantly lower prevalence of cirrhosis, ascites, portal hypertension, alpha-fetoprotein concentration ≥ 400 ng/mL, tumor size > 5 cm, multinodular tumors and microvascular invasion. Conversely, they showed significantly higher prevalence of metabolic syndrome, hypertension, type 2 diabetes, abdominal obesity, history of cardiovascular disease, T-wave alterations, hypertriglyceridemia and hyperuricemia, as well as higher risk of arteriosclerotic cardiovascular disease. Compared to patients with MAFLD but no hepatitis virus infection, those with concurrent MAFLD and chronic infection with HBV showed significantly higher prevalence of cirrhosis, ascites and portal hypertension, but significantly lower prevalence of hypertension and history of cardiovascular disease. Compared to patients with other etiologies, those chronically infected with HCV in the presence or absence of MAFLD and HBV infection, showed significantly higher prevalence of cirrhosis, portal hypertension, ascites, and esophagogastric varices.
CONCLUSIONS: Patients with HCC associated with MAFLD tend to have a background of less severe liver disease than those with HCC of other etiologies, but they may be more likely to suffer metabolic syndrome or comorbidities affecting the heart or kidneys.
METHODS: Medical records were retrospectively analyzed for patients with HCC who underwent hepatectomy between March 2013 and March 2023. Patients with HCC of different etiologies were compared in terms of their clinicodemographic characteristics and laboratory data before surgery.
RESULTS: Of the 2422 patients, 1,822 (75.2%) were chronically infected with HBV without MAFLD and HCV, 415 (17.2%) had concurrent MAFLD and chronic HBV infection but no HCV infection, 121 (5.0%) had MAFLD without hepatitis virus infection, and 64 (2.6%) were chronically infected with HCV in the presence or absence of MAFLD and HBV infection. Compared to patients chronically infected with HBV without MAFLD and HCV, those with MAFLD but no hepatitis virus infection showed significantly lower prevalence of cirrhosis, ascites, portal hypertension, alpha-fetoprotein concentration ≥ 400 ng/mL, tumor size > 5 cm, multinodular tumors and microvascular invasion. Conversely, they showed significantly higher prevalence of metabolic syndrome, hypertension, type 2 diabetes, abdominal obesity, history of cardiovascular disease, T-wave alterations, hypertriglyceridemia and hyperuricemia, as well as higher risk of arteriosclerotic cardiovascular disease. Compared to patients with MAFLD but no hepatitis virus infection, those with concurrent MAFLD and chronic infection with HBV showed significantly higher prevalence of cirrhosis, ascites and portal hypertension, but significantly lower prevalence of hypertension and history of cardiovascular disease. Compared to patients with other etiologies, those chronically infected with HCV in the presence or absence of MAFLD and HBV infection, showed significantly higher prevalence of cirrhosis, portal hypertension, ascites, and esophagogastric varices.
CONCLUSIONS: Patients with HCC associated with MAFLD tend to have a background of less severe liver disease than those with HCC of other etiologies, but they may be more likely to suffer metabolic syndrome or comorbidities affecting the heart or kidneys.
摘要：
目的：本研究比较了与代谢功能障碍相关的脂肪肝（MAFLD）相关的肝细胞癌（HCC）患者中代谢综合征和心脏或肾脏合并症的患病率，慢性乙型或丙型肝炎病毒（HBV或HCV）感染，或MAFLD和慢性HBV感染的组合。
方法：回顾性分析2013年3月至2023年3月期间接受肝切除术的HCC患者的病历。比较不同病因的HCC患者的临床人口学特征和手术前的实验室数据。
结果：在2422名患者中，1,822（75.2％）慢性感染HBV无MAFLD和HCV，415（17.2％）并发MAFLD和慢性HBV感染，但没有HCV感染，121例（5.0%）MAFLD无肝炎病毒感染，在存在或不存在MAFLD和HBV感染的情况下，有64例（2.6％）慢性感染HCV。与慢性HBV感染无MAFLD和HCV的患者相比，那些MAFLD，但没有肝炎病毒感染显示肝硬化的患病率显着降低，腹水,门静脉高压症,甲胎蛋白浓度≥400ng/mL，肿瘤大小>5厘米，多结节性肿瘤和微血管侵犯。相反，他们显示代谢综合征的患病率明显更高，高血压,2型糖尿病,腹部肥胖，心血管疾病史,T波改变,高甘油三酯血症和高尿酸血症，以及动脉硬化性心血管疾病的高风险。与MAFLD但无肝炎病毒感染的患者相比，那些并发MAFLD和慢性感染HBV显示肝硬化的患病率显着升高，腹水和门静脉高压症，但高血压和心血管疾病史的患病率明显较低。与其他病因患者相比，那些在存在或不存在MAFLD和HBV感染的慢性HCV感染，显示肝硬化的患病率明显较高，门静脉高压症,腹水,和食管胃静脉曲张.
结论：与MAFLD相关的HCC患者往往具有比其他病因的HCC更不严重的肝脏疾病的背景，但他们可能更容易患代谢综合征或合并症，影响心脏或肾脏。
方法：回顾性分析2013年3月至2023年3月期间接受肝切除术的HCC患者的病历。比较不同病因的HCC患者的临床人口学特征和手术前的实验室数据。
结果：在2422名患者中，1,822（75.2％）慢性感染HBV无MAFLD和HCV，415（17.2％）并发MAFLD和慢性HBV感染，但没有HCV感染，121例（5.0%）MAFLD无肝炎病毒感染，在存在或不存在MAFLD和HBV感染的情况下，有64例（2.6％）慢性感染HCV。与慢性HBV感染无MAFLD和HCV的患者相比，那些MAFLD，但没有肝炎病毒感染显示肝硬化的患病率显着降低，腹水,门静脉高压症,甲胎蛋白浓度≥400ng/mL，肿瘤大小>5厘米，多结节性肿瘤和微血管侵犯。相反，他们显示代谢综合征的患病率明显更高，高血压,2型糖尿病,腹部肥胖，心血管疾病史,T波改变,高甘油三酯血症和高尿酸血症，以及动脉硬化性心血管疾病的高风险。与MAFLD但无肝炎病毒感染的患者相比，那些并发MAFLD和慢性感染HBV显示肝硬化的患病率显着升高，腹水和门静脉高压症，但高血压和心血管疾病史的患病率明显较低。与其他病因患者相比，那些在存在或不存在MAFLD和HBV感染的慢性HCV感染，显示肝硬化的患病率明显较高，门静脉高压症,腹水,和食管胃静脉曲张.
结论：与MAFLD相关的HCC患者往往具有比其他病因的HCC更不严重的肝脏疾病的背景，但他们可能更容易患代谢综合征或合并症，影响心脏或肾脏。
