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학술저널
저자정보
Teng Pai-Chi (Division of Urology Department of Surgery Cardinal Tien Hospital New Taipei TaiwanDepartment of Urology National Taiwan University Hospital Taipei TaiwanSamuel Oschin Comprehensive Cancer Institute Ce) Huang Daniel Q. (Department of Medicine Yong Loo Lin School of Medicine National University of SingaporeDivision of Gastroenterology and Hepatology Department of Medicine National University Health System Singapore) Lin Ting-Yi (Doctoral Degree Program of Translational Medicine National Yang Ming Chiao Tung University and Academia Sinica Taipei Taiwan) Noureddin Mazen (Karsh Division of Gastroenterology and Hepatology Cedars-Sinai Medical Center Los Angeles CA USA) Yang Ju Dong (Samuel Oschin Comprehensive Cancer Institute Cedars-Sinai Medical Center Los Angeles CA USAKarsh Division of Gastroenterology and Hepatology Cedars-Sinai Medical Center Los Angeles CA USAComprehensive)
저널정보
거트앤리버 발행위원회 Gut and Liver Gut and Liver 제17권 제1호
발행연도
2023.1
수록면
24 - 33 (10page)
DOI
10.5009/gnl220357

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Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in the world. NAFLD is a hepatic manifestation of insulin resistance, the core pathophysiology of diabetes. Multiple clinical studies show that diabetes increases the risk of liver disease progression and cirrhosis development in patients with NAFLD. Diabetes has causal associations with many different cancers, including hepatocellular carcinoma (HCC). More recent studies demonstrate that diabetes increases the risk of HCC in patients with underlying NAFLD cirrhosis, confirming the direct hepatocarcinogenic effect of diabetes among cirrhosis patients. Diabetes promotes hepatocarcinogenesis via the activation of inflammatory cascades producing reactive oxygen species and proinflammatory cytokines, leading to genomic instability, cellular proliferation, and inhibition of apoptosis. Given the global increase in the burden of NAFLD and HCC, high-risk patients such as older diabetic individuals should be carefully monitored for HCC development. Future larger studies should explore whether the effect of diabetes on HCC risk in NAFLD cirrhosis is modifiable by the type of antidiabetic medication and the effectiveness of diabetes control.

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