Metabolic dysfunction-associated steatotic liver disease and urinary system cancers: Mere coincidence or reason for concern?

• Published in: Metabolism, clinical and experimental clinical and experimental, 2025-01, Vol.162, p.156066, Article 156066
• Main Authors: Bril, Fernando, Elbert, Alicia
• Format: Article
• Language: English
• Subjects: Bladder cancer; Fatty Liver - complications; Fatty Liver - metabolism; Fatty Liver - physiopathology; Humans; Insulin Resistance - physiology; Male; MASH; MASLD; Metabolic Diseases - complications; Metabolic Diseases - metabolism; Metabolic Diseases - physiopathology; Prostate adenocarcinoma; Prostatic Neoplasms - complications; Prostatic Neoplasms - metabolism; RCC; Urologic Neoplasms - complications; Urologic Neoplasms - metabolism
• ISSN: 0026-0495; 1532-8600; 1532-8600
• DOI: 10.1016/j.metabol.2024.156066

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a systemic disease characterized by insulin resistance and lipotoxicity. Its association with type 2 diabetes, cardiovascular disease, liver cirrhosis, and hepatocellular carcinoma are well described. However, the association of MASLD and extra-hepatic cancers has received significantly less attention. This narrative review will summarize the conflicting evidence regarding the association between MASLD and cancers of the urinary system, including renal cell carcinoma, urothelial carcinoma, and prostate adenocarcinoma. It will explore potential mechanisms that could be responsible for a higher risk of urinary system cancers in patients with MASLD. We hope that our comprehensive assessment of the literature will help the readers to better interpret the available evidence. •MASLD is associated with urinary system cancers in observational studies.•There is high heterogeneity among studies and results have been inconsistent.•It is hard to establish if MASLD per se increases the risk of urinary system cancers•Several confounding factors (e.g., hyperinsulinemia, hyperglycemia, obesity) may be affecting the association.•Presence of MASLD should not affect the management of urinary system cancers.