Hepatocellular carcinoma in nonalcoholic fatty liver: Role of environmental and genetic factors

Table 1 Literature supporting increased incidence of hepatocellular carcinoma diagnosed in non-cirrhotic liver in nonalcoholic fatty liver disease

Ref.	Cases (n)	Other etiologies (n)	Cryptogenic cirrhosis (n)	Design
Marrero et al[25]	105	75	30	Population study
Bugianesi et al[20]	641	597	44	Retrospective case-control study
Regimbeau et al[26]	210	192	18	Case-control study
Lee et al[27]	480	446	34	Case-control study
Pekow et al[36]	32	32	-	Retrospective case-control study
Ascha et al[30]	89	64	25	Case-control study

HCC: Hepatocellular carcinoma; NAFLD: Nonalcoholic fatty liver disease.

Table 2 Ascertained risk factors for hepatocellular carcinoma in fatty liver

Risk factors
Age
Male gender
HCV/HBV[3,30,31,36-38]
Alcohol abuse[34,35]
Severity of NAFLD/NASH[25,28-30,33,39]
Diabetes/obesity[26,31,43-46]
Iron overload[69-71]
Genetic variants (PNPLA3, APOB, TERT)[92-94,100,104,111,113,114]
Hepatic stellate cells (HSCs) activation and senescence[118,119]

HCV: Hepatitis C virus; HBV: Hepatitis B virus; NAFLD: Nonalcoholic fatty liver disease; NASH: Nonalcoholic steatohepatitis; PNPLA3: Patatin-like phospholipase domain-containing protein 3; APOB: Apolipoprotein B; TERT: Telomerase reverse transcriptase.