Understanding the Role of Metabolic Syndrome as a Risk Factor for Hepatocellular Carcinoma

Norberto C Chavez-Tapia,1,2 Sofía Murúa-Beltrán Gall,1 Ana Luisa Ordoñez-Vázquez,1 Natalia Nuño-Lambarri,2 Paulina Vidal-Cevallos,1 Misael Uribe1 1Gastroenterology Department, Medica Sur Clinic & Foundation, Mexico City, Mexico; 2Transational Research Department, Medica Sur Clinic & Foundation, Mexico City, MexicoCorrespondence: Norberto C Chavez-Tapia, Gastroenterology Department, Medica Sur Clinic & Foundation, Puente de Piedra 150. Col. Toriello Guerra, Tlalpan, Mexico City, CP 14050, Mexico, Email nchavezt@medicasur.org.mxAbstract: Hepatocellular carcinoma (HCC) and metabolic syndrome (MetS) have a rising prevalence worldwide. The relationship between these two entities has long been studied and understanding it has become a public health and clinical priority. This association follows, in most patients, the path through non-alcoholic fatty liver disease (NAFLD), non-alcoholic steatohepatitis (NASH), cirrhosis and finally HCC. Nonetheless, increasing evidence has been found, that shows MetS as an independent risk factor for the development of HCC. This review brings together the clinical evidence of the relationship between these highly prevalent diseases, with a particular interest in the impact of each component of MetS on HCC; It aims to summarize the complex physiopathological pathways that explain this relationship, and to shed light on the different clinical scenarios of this association, the impact of treating the different components of MetS on the risk of HCC and what is known about screening for HCC in patients with MetS. By doing so, it hopes to improve awareness on this topic.Keywords: metabolic syndrome, hepatocellular carcinoma, excess body weight, diabetes mellitus, non-alcoholic fatty liver disease