Proportion of metabolic syndrome in hepatocellular carcinoma patients with different etiologies: a retrospective study

Aims: This study aims to compare the proportion of metabolic syndrome (MetS) and cardiac or kidney comorbidities in patients with hepatectomy hepatocellular carcinoma (HCC) in the context of metabolic dysfunction-related fatty liver disease (MAFLD), chronic hepatitis B (CHB), concurrent CHB/MAFLD, or hepatitis C virus infection. Methods This retrospective study included patients with biopsy-proven HCC between March 2013 and March 2023. Cases were divided into MAFLD, CHB, CHB/MAFLD, and HCV groups. Preoperative demographic, clinical, and laboratory data were collected to compare the proportion of MetS and cardiac or kidney comorbidities. Results The proportions in the MAFLD, CHB, CHB/MAFLD, and HCV groups were 5.0% (n = 121), 75.2% (n = 1,822), 17.2% (n = 415), and 2.6% (n = 64), respectively. MAFLD patients had significantly lower proportions of cirrhosis, ascites, portal hypertension, alpha fetoprotein concentration ≥ 400 ng/mL, tumor size > 5cm, multinodular tumours, and microvascular invasion, but had significantly higher proportions of hypertension, type 2 diabetes, overweight, history of cardiovascular diseases, high arteriosclerotic cardiovascular disease risk, T-wave changes, hypertriglyceridemia, and hyperuricemia than CHB patients. CHB/MAFLD patients also had higher proportion of cirrhosis, ascites, and portal hypertension, but lower proportion of hypertension, overweight, and history of cardiovascular diseases compared to MAFLD patients (all p < 0.05). HCV group had higher proportion of cirrhosis, portal hypertension, ascites, and esophagogastric varices. Conclusion HCC patients in the setting of MAFLD have less severe liver disease but with higher proportion of MetS and cardiac or kidney comorbidities.