Nonalcoholic Fatty liver disease, diabetes, obesity, and hepatocellular carcinoma.
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.
Division of Gastrointestinal and Liver Diseases, USC Keck School of Medicine, 2011 Zonal Avenue, HMR 101, Los Angeles, CA 90033, USA.
Mazen
M
Noureddin
Division of Gastroenterology and Hepatology, Northwestern University Feinberg School of Medicine, 676 North Saint Clair, Arkes Pavillion 14-005, Chicago, IL 60611, USA. Electronic address: m-rinella@northwestern.edu.
Mary E
ME
Rinella
D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000517:prevention & control; D018890:Chemoprevention; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000503:physiopathology*; D059865:Endoplasmic Reticulum Stress; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D015994:Incidence; D007249:Inflammation / Q000453:epidemiology; D007333:Insulin Resistance; D048031:JNK Mitogen-Activated Protein Kinases / Q000378:metabolism; D020738:Leptin / Q000378:metabolism; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000517:prevention & control; D008687:Metformin / Q000627:therapeutic use; D065626:Non-alcoholic Fatty Liver Disease / Q000453:epidemiology / Q000503:physiopathology*; D009765:Obesity / Q000453:epidemiology / Q000503:physiopathology*; D012307:Risk Factors; D012436:S-Adenosylmethionine / Q000378:metabolism; D051193:Toll-Like Receptors / Q000378:metabolism
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007004:Hypoglycemic Agents; D020738:Leptin; D051193:Toll-Like Receptors; D012436:S-Adenosylmethionine; D008687:Metformin; D048031:JNK Mitogen-Activated Protein Kinases
Chemoprevention; Cirrhosis; Diabetes; Hepatocellular carcinoma; Insulin resistance; Nonalcoholic steatohepatitis; Noncirrhotic; Obesity