Affiliations 

  • 1 Department of Gastroenterology, The Fifth Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
  • 2 Department of Medicine, University of Verona, Verona, Italy
  • 3 Southampton National Institute for Health and Care Research Biomedical Research Centre, University Hospital Southampton and University of Southampton, Southampton General Hospital, Southampton, UK
  • 4 Department of Liver Surgery, Peking Union Medical College (PUMC) Hospital, Peking Union Medical College (PUMC) & Chinese Academy of Medical Sciences (CAMS), Beijing, China
  • 5 Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
  • 6 Department of Gastroenterology, School of Medicine, Recep Tayyip Erdoğan University, Rize, Türkiye
  • 7 Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
  • 8 Liver Research Unit, Medica Sur Clinic & Foundation and Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
  • 9 Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
  • 10 Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • 11 Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
  • 12 Department of Gastroenterology and Hepatology, Kiang Wu Hospital, Macau, China
  • 13 Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea
  • 14 Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, Sydney, Australia
  • 15 Department of Liver Surgery, Sun Yat-Sen University Cancer Center, Guangzhou, China
  • 16 Division of Gastroenterology and Hepatology, Chronic Viral Illness Service, McGill University Health Centre, Royal Victoria Hospital, Montreal, Canada
  • 17 Department of Hepatology, RCSI School of Medicine and Medical Sciences, Beaumont Hospital, Dublin, Ireland
  • 18 Nacogdoches Center for Metabolic & Weight Loss Surgery, Nacogdoches Medical Center, Nacogdoches, Texas, USA
  • 19 Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning, China
  • 20 Department of Internal Medicine II, Saarland University Medical Center, Homburg, Germany
  • 21 Department of Internal Medicine, Ospedale Civile di Baggiovara (-2023), Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
  • 22 Department of Metabolic, Bariatric and Endocrine Surgery, Fuenlabrada University Hospital, Madrid, Spain
  • 23 Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China
  • 24 Physiology Research Center, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
  • 25 Department of Medicine, Makerere University of College of Health Sciences, Kampala, Uganda
  • 26 Department of Medical Imaging, "Prof. Dr. Octavian Fodor" Regional Institute of Gastroenterology and Hepatology, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
  • 27 Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Naval Medical University, Shanghai, China
  • 28 Gastroenterology and Hepatology Service, Yerevan Scientific Medical Center, Yerevan, Armenia
  • 29 Department of Gastroenterology and Hepatology, Erasmus MC-University Medical Center, Rotterdam, the Netherlands
  • 30 Department of Medicine, Aga Khan University, Karachi, Pakistan
  • 31 Department of Hepatology, Sir Charles Gairdner Hospital, Perth, Australia
  • 32 Department of Gastroenterology, The First Affiliated Hospital (Southwest Hospital), Third Military Medical University (Army Medical University), Chongqing, China
  • 33 Surgical Gastroenterology, Bariatric and Robotic Surgery, Apollo Hospital, New Delhi, India
  • 34 Department of Medicine, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
  • 35 Liver Disease Research Center, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
  • 36 Department of Gastroenterology and Hepatology, Federal Research Center for Nutrition, Biotechnology and Food Safety, Moscow, Russian Federation
  • 37 Department of Hepatology and Liver Transplant, Institute of Liver and Biliary Sciences, New Delhi, India
  • 38 Division of Gastroenterology and Hepatology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
  • 39 Gastroenterology Section, Department of Medicine, King Abdulaziz Medical City, King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
  • 40 Department of Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
  • 41 Department of Medicine, Aga Khan University, Nairobi, Kenya
  • 42 Universidad San Ignacio de Loyola, Lima, Peru
  • 43 Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
  • 44 Department of Gastroenterology & Hepatology, Changi General Hospital, Singapore
  • 45 Department of Surgery, Humanitas University, School of Medicine, Milano, Italy
  • 46 Department of Gastroenterology, Hepatology and Endemic Medicine, Faculty of Medicine, Minia University, Minia, Egypt
  • 47 MAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
Am J Gastroenterol, 2025 Jan 03.
PMID: 39749919 DOI: 10.14309/ajg.0000000000003288

Abstract

INTRODUCTION: The global burden of metabolic diseases is increasing, but estimates of their impact on primary liver cancer are uncertain. We aimed to assess the global burden of primary liver cancer attributable to metabolic risk factors, including high body mass index (BMI) and high fasting plasma glucose (FPG) levels, between 1990 and 2021.

METHODS: The total number and age-standardized rates of deaths and disability-adjusted life years (DALYs) from primary liver cancer attributable to each metabolic risk factor were extracted from the Global Burden of Disease Study 1990-2021. The metabolic burden trends of liver cancer across regions and countries by sociodemographic index (SDI) and sex were estimated. The annual percentage changes in age-standardized DALYs rate were also calculated.

RESULTS: Globally, in 2021, primary liver cancer attributable to high BMI and/or high FPG was estimated to have caused 59,970 deaths (95% uncertainty interval [UI] 20,567-104,103) and 1,540,437 DALYs (95% UI 540,922-2,677,135). The age-standardized rates of death and DALYs were 0.70 (95% UI 0.24-1.21) and 17.64 (95% UI 6.19-30.65) per 100,000 person-years. A consistent global rise in liver cancer attributable to metabolic risks was observed from 1990 to 2021, with high BMI identified as the major contributing risk factor. The highest burden of deaths and DALYs of liver cancer consistently occurred in high SDI countries, while the fastest growth trends were observed in low-middle SDI countries. The burdens of high levels of BMI and FPG were higher in men than in women.

DISCUSSION: Primary liver cancer attributable to high BMI and/or high FPG imposes an increasingly substantial clinical burden on global public health, particularly in high SDI countries. Rapid growth trends are also found in middle SDI countries.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.