Risk factors for hepatocellular carcinoma in cirrhosis due to nonalcoholic fatty liver disease: A multicenter, case-control study

Table 1 Characteristics of cases and controls

Characteristic		Case (n = 94)	Control (n = 150)	P value
Age, yr (mean ± SD)		61.9 ± 9.4	58.0 ± 9.9	0.002
Gender	Female	33%	55%	< 0.001
	Male	67%	45%
Race	White	85%	80.0%	0.605
	Black	1%	17%
	Other	14%	3%
Ethnicity	Not Hispanic	82%	90%	0.149
	Hispanic	18%	10%
Diabetes mellitus	Yes	74%	67%	0.237
	No	26%	33%
Hypertension	Yes	61%	60%	0.888
	No	39%	40%
Dyslipidemia	Yes	50%	47%	0.609
	No	50%	53%
Cardiovascular disease	Yes	28%	19%	0.093
	No	72%	81%
Metformin use	Yes	40%	37%	0.660
	No	60%	63%
Statin use	Yes	25%	21%	0.401
	No	75%	79%
Vitamin E use	Yes	11%	9%	0.620
	No	89%	91%
Ascites	Yes	51%	47%	0.628
	No	49%	53%
Gastroesophageal varices	Yes	66%	53%	0.072
	No	34%	47%
Hepatic encephalopathy	Yes	40%	40%	0.995
	No	60%	60%
Complications of cirrhosis	Yes	83%	71%	0.032
	No	17%	29%
BMI (kg/m2)		32.8 ± 5.8	33.9 ± 7.3	0.222
ALT (IU/L) (mean ± SD)		43.3 ± 25.4	42.18 ± 37.3	0.819
MELD score (mean ± SD)		11.6 ± 4.4	12.39 ± 4.8	0.382

BMI: Body mass index; ALT: Alanine aminotransferase; MELD: Model for end-stage liver disease.

Table 2 Variables associated with presence of hepatocellular carcinoma on multivariate analysis¹

Variable	Univariate P value	Multivariate OR 95%CI	Multivariate P value
Age	0.002	1.08 (1.032-1.13)	0.001
Gender	< 0.001	4.34 (1.83-10.31)	< 0.001
BMI	0.22	0.96 (0.90-1.02)	0.20
Ethnicity	0.15	0.300 (0.090-0.994)	0.045
Platelet count	0.14	1.004 (1.00-1.01)	0.14
CVD	0.09	1.21 (0.61-2.41)	0.58
Gastroesophageal varices	0.07	1.43 (0.63-3.21)	0.39
Complications of cirrhosis	0.03	1.15 (0.43-3.02)	0.78

¹The final model was selected by combining clinical judgment and statistical assessment. We included variables with P < 0.1 in univariate analysis and variables that are considered as known confounders. CVD: Cardiovascular disease; BMI: Body mass index.

Table 3 Tumor characteristics of hepatocellular carcinoma

Characteristics of HCC	n (%)
Primary tumor (T)
1	27 (42.86)
2	28 (44.44)
3	8 (12.70)
Regional lymph nodes (N)
Yes	2 (2.63)
No	43 (56.58)
Unknown	31 (40.79)
Distant metastasis (M)
Yes	5 (6.33)
No	45 (56.96)
Unknown	29 (36.71)
Tumor size, median (IQR)	2.7 (2.5)
Number of lesions, median (IQR)	1.0 (1.0)
Vascular invasion
Yes	11 (13.92)
No	56 (70.89)
Unknown	12 (15.19)
Perineural invasion
Yes	1 (1.30)
No	51 (66.23)
Unknown	25 (32.47)
Bilobar involvement of tumor
Yes	21 (25.61)
No	45 (54.88)
Unknown	16 (19.51)

HCC: Hepatocellular carcinoma.