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

• Published in: Cancer epidemiology 2023-06, Vol.84, p.102362-102362, Article 102362
• Main Authors: Zhang, Lizhen, Wang, Zhongge, Chen, Ruirui, Cheng, Zhiyuan, Yang, Jingli, Li, Jing, Li, Siyu, Chen, Yarong, Xu, Lulu, Hu, Yujia, Bai, Yana
• Format: Article
• Language: English
• Subjects: Alanine; Alanine aminotransferase; Alanine Transaminase; Alcohol; Blood Glucose; Cancer; Carcinoma, Hepatocellular - epidemiology; Case-Control Studies; Cholesterol; Cohort analysis; Cohort study; Confidence intervals; Data collection; Diabetes; Diabetes mellitus; Epidemiology; Family medical history; Fasting; Fasting plasma glucose; Glucose; Glucose metabolism; Hepatitis; Hepatocellular carcinoma; Hospitals; Humans; Insulin resistance; Interaction; Interaction models; Liver cancer; Liver Neoplasms - epidemiology; Prospective Studies; Public health; Regression analysis; Risk Factors; Risk management; Software; Synergistic effect; Transaminases
• ISSN: 1877-7821; 1877-783X
• DOI: 10.1016/j.canep.2023.102362

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. 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. 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). 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. [Display omitted] •A nested case-control method was used to explore the relationship between FPG and ALT and the incidence of HCC.•Abnormal FPG and ALT were independently associated with the risk of HCC.•Abnormal FPG and ALT have a synergistic effect on the risk of HCC.