Effect of metabolic dysfunction‑associated fatty liver disease on the risk of hepatocellular carcinoma in patients with chronic hepatitis B: A systematic review and meta‑analysis

Shen,Sixing; Shen,Sixing; Pan,Lingyan; Pan,Lingyan

doi:10.3892/etm.2024.12387

Effect of metabolic dysfunction‑associated fatty liver disease on the risk of hepatocellular carcinoma in patients with chronic hepatitis B: A systematic review and meta‑analysis

Authors:
- Sixing Shen
- Lingyan Pan
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Affiliations: Department of Hepatobiliary and Pancreatic Surgery, Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, Huzhou, Zhejiang 313000, P.R. China, Department of Infectious Disease, Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, Huzhou, Zhejiang 313000, P.R. China
Published online on: January 15, 2024 https://doi.org/10.3892/etm.2024.12387
Article Number: 99
Copyright: © Shen et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Hepatocellular carcinoma (HCC) remains an important complication in patients with chronic hepatitis B (CHB). An association between the presence of metabolic dysfunction‑associated fatty liver disease (MAFLD) and an increased HCC risk in patients with CHB may exist; however, the exact nature of this possible association remains unclear. The present study conducted a comprehensive meta‑analysis by pooling data from 18 studies encompassing 23,927 participants. The odds ratios (ORs) were calculated using a random‑effects inverse‑variance model, and heterogeneity was assessed using Cochran's Q test and the I² statistic. In addition, subgroup analyses were performed on the basis of geographical region, study design and follow‑up length. Publication bias and meta‑regression were also assessed. The overall pooled OR for the association between MAFLD and HCC risk in patients with CHB was 1.053 (95% CI, 0.704‑1.576), which suggested a lack of association. Heterogeneity was observed across studies. Subgroup analyses demonstrated a potentially protective effect for MAFLD on the risk of HCC in patients in Asian countries (OR, 0.783; 95% CI, 0.568‑1.080) and the opposite effect in other regions (OR, 4.380; 95% CI, 2.440‑7.864). Analysis of the prospective cohort studies suggested a significant protective effect for MAFLD (OR, 0.479; 95% CI, 0.365‑0.629), while analysis of retrospective cohorts did not. The publication bias assessment was inconclusive and the meta‑regression failed to identify heterogeneity sources. The association between MAFLD and HCC risk in patients with CHB appeared to be multifactorial and may vary on the basis of geographical region and study design. While the exact mechanisms remain elusive, the potential protective effect demonstrated in certain subgroups warrants further investigation.

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