Fasting plasma glucose and alanine aminotransferase on the risk of hepatocellular carcinoma: A nested case-control study

Zhang，Lizhen1; Wang，Zhongge1; Chen，Ruirui1; Cheng，Zhiyuan2; Yang，Jingli1; Li，Jing1; Li，Siyu1; Chen，Yarong1; Xu，Lulu1; Hu，Yujia1; Bai，Yana1

2023-06-01

10.1016/j.canep.2023.102362

Cancer Epidemiology   Impact Factor & Quartile

1877-7821

1877-783X

Background: The risk of hepatocellular carcinoma (HCC) is associated with a variety of factors. However, the possible association between the abnormal metabolism of fasting plasma glucose (FPG) and alanine aminotransferase (ALT) and the risk of HCC has not been widely studied. We examined this relationship based on a prospective cohort study. Methods: 162 first-attack HCC cases during three follow-up periods (2014–2020) were selected as the case group. A control group of 648 participants was obtained by 1:4 matching of age (± 2 years) and sex with noncancer participants in the same period. Conditional logistic regression models, restricted cubic spline models, additive interaction models, and generalized additive models were used to explore the effects of FPG and ALT on the risk of HCC. Results: After correction for confounding factors, we found that abnormal FPG and elevated ALT increased the risk of HCC, respectively. Compared with the normal FPG group, the risk of HCC was significantly increased in the impaired fasting glucose (IFG) (OR = 1.91, 95 %CI: 1.04, 3.50) and diabetes groups (OR = 2.12, 95 %CI: 1.24, 3.63). Compared with the lowest quartile of ALT, subjects in the fourth quartile had an 84 % increased risk of HCC (OR = 1.84, 95 %CI: 1.05–3.21). Moreover, there was an interaction between FPG and ALT on the risk of HCC, and 74 % of the HCC risk could be attributed to their synergistic effect (AP = 0.74, 95 %CI: 0.56–0.92). Conclusion: Abnormal FPG and elevated ALT are independent risk factors for HCC, and they have a synergistic effect on the risk of HCC. Therefore, serum FPG and ALT levels should be monitored to prevent the development of HCC.

Alanine aminotransferase Cohort study Fasting plasma glucose Hepatocellular carcinoma Interaction

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National Natural Science Foundation of China[81673248];

2-s2.0-85151497245

Scopus

1.Department of Epidemiology and Health Statistics,School of Public Health,Lanzhou University,Lanzhou,730000,China
2.School of Public Health and Emergency Management,Southern University of Science and Technology,Shenzhen,1088 Xueyuan Street,518055,China

Zhang，Lizhen,Wang，Zhongge,Chen，Ruirui,et al. Fasting plasma glucose and alanine aminotransferase on the risk of hepatocellular carcinoma: A nested case-control study[J]. Cancer Epidemiology,2023,84.

Zhang，Lizhen.,Wang，Zhongge.,Chen，Ruirui.,Cheng，Zhiyuan.,Yang，Jingli.,...&Bai，Yana.(2023).Fasting plasma glucose and alanine aminotransferase on the risk of hepatocellular carcinoma: A nested case-control study.Cancer Epidemiology,84.

Zhang，Lizhen,et al."Fasting plasma glucose and alanine aminotransferase on the risk of hepatocellular carcinoma: A nested case-control study".Cancer Epidemiology 84(2023).