Adiponectin accounts for gender differences in hepatocellular carcinoma incidence

Manieri, Elisa; Herrera-Melle, Leticia; Mora, Alfonso; Tomás-Loba, Antonia; Leiva‐Vega, Luis; Fernández, Delia I.; Rodrı́guez, Elena; Morán, L. Ortega; Hernández‐Cosido, Lourdes; Torres, Jorge; Seoane, Luísa M.; Cubero, Francisco Javier; Marcos, Miguel; Sabio, Guadalupe

doi:10.1084/jem.20181288

Cited by 76 publications

(53 citation statements)

References 33 publications

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“…Epidemiological studies have shown a higher incidence of HCC in men than in women. A possible reason is that higher adiponectin in women could activate AMPKα and p38α which confers protection against HCC . Admittedly, hepatitis, AFP, sex, and CA199 have been demonstrated to distinguish ICC from HCC in many studies which are consistent with our conclusion, while lower ANRI in ICC than in HCC has never been investigated .…”

Section: Discussionsupporting

confidence: 80%

Nomogram based on inflammatory indices for differentiating intrahepatic cholangiocarcinoma from hepatocellular carcinoma

et al. 2020

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Objective To establish nomogram based on inflammatory indices for differentiating intrahepatic cholangiocarcinoma (ICC) from hepatocellular carcinoma (HCC). Methods A cohort of 422 patients with HCC or ICC hospitalized at Xiangya Hospital between January 2014 and December 2018 was included in the study. Univariate and multivariate analysis was performed to identify the independent differential factors. Through combining these independent differential factors, a nomogram was established for differential diagnosis between ICC and HCC. The accuracy of nomogram was evaluated by using receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA). The results were validated using a prospective study on 98 consecutive patients operated on from January 2019 to November 2019 at the same institution. Results Sex (OR = 9.001, 95% CI: 3.268‐24.792, P < .001), hepatitis (OR = 0.323, 95% CI: 0.121‐0.860, P = .024), alpha‐fetoprotein (AFP) (OR = 0.997, 95% CI: 0.995‐1.000, P = .046), carbohydrate antigen 19‐9 (CA199) (OR = 1.016, 95% CI: 1.007‐1.025, P < .001), and aspartate transaminase‐to‐neutrophil ratio index (ANRI) (OR = 0.904, 95% CI: 0.843‐0.969, P = .004) were the independent differential factors for ICC. Nomogram was established with well‐fitted calibration curves through incorporating these 5 factors. Comparing model 1 including gender, hepatitis, AFP, and CA199 (C index = 0.903, 95% CI: 0.849‐0.957) and model 2 enrolling AFP and CA199 (C index = 0.850, 95% CI: 0.791‐0.908), the nomogram showed a better discrimination between ICC and HCC, with a C index of 0.920 (95% CI, 0.872‐0.968). The results were consistent in the validation cohort. DCA also confirmed the conclusion. Conclusion A nomogram was established for the differential diagnosis between ICC and HCC preoperatively, and better therapeutic choice would be made if it was applied in clinical practice.

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Section: Discussionsupporting

confidence: 80%

Nomogram based on inflammatory indices for differentiating intrahepatic cholangiocarcinoma from hepatocellular carcinoma

et al. 2020

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“…Sex disparities in HCC incidence have been described across the globe, with men disproportionately affected compared to women in a 2:1‐4:1 ratio, depending on region 3‐5 . This disparity is partly driven by differences in the prevalence of established HCC risk factors, including viral hepatitis, alcohol use and metabolic syndrome between men and women 6 ; however, sex hormones (eg oestrogen, androgens) and other biological factors, such as adiponectin, have also been implicated 7‐9 …”

Section: Introductionmentioning

confidence: 99%

Sex disparities in presentation and prognosis of 1110 patients with hepatocellular carcinoma

Rich

Murphy

Yopp

et al. 2020

Aliment Pharmacol Ther

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Summary Background Although sex disparities in hepatocellular carcinoma (HCC) incidence have been well described, there are limited data examining sex disparities in HCC prognosis. Aim To characterise sex differences in HCC presentation and prognosis. Methods We performed a retrospective study of consecutive patients (n = 1110, 23.5% women) diagnosed with HCC between 2008 and 2017 at two US health systems. We used Cox proportional hazard and multivariable logistic regression models to identify factors associated with overall survival, early tumour detection and response to HCC treatment (per the modified Response Evaluation Criteria in Solid Tumors [mRECIST] criteria). Results Women were older at HCC diagnosis (mean 62.5 vs 59.2 years, P < 0.001) and had a higher proportion of early‐stage tumours (53.1% vs 43.7% Barcelona Clinic Liver Cancer [BCLC] stage 0/A, P = 0.04), but similar liver function compared to men (49.2% vs 47.1% Child Pugh A, P = 0.27). In univariable analysis, women had significantly better overall survival than men (median 17.1 vs 12.0 months, P = 0.02). When stratified by age, younger (<65 years) women had better overall survival than men (18.3 vs 11.2 months, P = 0.02); however, older (≥65 years) women and men had similar overall survival (15.5 vs 15.7 months, P = 0.45). In multivariable analysis, female sex was independently associated with lower mortality after adjusting for age, race/ethnicity, alpha‐fetoprotein, BCLC stage, Albumin‐Bilirubin grade and Child Pugh score (hazard ratio [HR] 0.82, 95% confidence interval [CI] 0.68‐0.98). In secondary analyses, female sex was independently associated with early tumour detection (odds ratio [OR] 1.46, 95% CI 1.05‐2.02) and response to first HCC treatment (OR 1.72, 95% CI 1.18‐2.53) after adjusting for the same covariates. Conclusion In a large cohort of patients with HCC, women had significantly better prognosis than men.

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“…It is unlikely that health seeking behavior of patients accounts for this gender disparity, as women more readily utilize outpatient services in Ghana (19). Of the few studies that have investigated why more males than females develop HCC, one study described the in uence of estrogen in reducing interleukin-6 and subsequently reducing tumorigenesis (20), whilst a more recent study suggested that the cause might be related to the fact that men produce lower levels of the hormone adiponectin (21).…”

Section: Discussionmentioning

confidence: 99%

Ambulatory end-stage liver disease in Ghana; patient profile and utility of alpha fetoprotein and aspartate aminotransferase - platelet ratio index.

Nartey

Awuku

Agyei-Nkansah

et al. 2020

Preprint

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Background: End-stage liver disease (ESLD) is a major burden on public health, particularly in sub-Saharan Africa, where hepatitis B virus (HBV) is an important risk factor. We aimed to describe clinical characteristics of ESLD from cirrhosis or hepatocellular carcinoma (HCC) and the performance of aspartate aminotransferase (AST) - platelet ratio index (APRI) and alpha fetoprotein (AFP) in Ghana. Methods: We performed an observational cross-sectional study in outpatient hepatology clinics at three teaching hospitals in Ghana, West Africa. One hundred and forty-one HCC, 216 cirrhosis and 218 chronic HBV patients were recruited by convenience sampling. Sociodemographic, history and examination, laboratory, and disease staging information were shown using descriptive statistics. Performance of the APRI score in diagnosis of cirrhosis and AFP in the diagnosis of HCC was determined using AUROC analysis.Results: Median age at presentation was 44 years for HCC and 46 years for cirrhosis. HBV was found in 69.5% of HCC and 47.2% of cirrhosis cases, and HCV in 6.4% and 3.7% respectively. APRI cut-off of 2 had sensitivity of 45.4% and specificity of 95% in diagnosis of cirrhosis, and cut-off of 1 had sensitivity of 75.9% and specificity of 89%. AUC of AFP was 0.88 (95% CI 0.81-0.94) in diagnosis of HCC. Low monthly income was associated with lower odds of undertaking AFP. Thirty one percent of cirrhotic persons were Child-Pugh C, and 67.9% of HCC patients had advanced or terminal disease at presentation. Conclusions: Our findings emphasize the young age of ESLD patients in Ghana and the advanced nature at presentation. It highlights shortcomings in surveillance and the need for policies to address the burden and improve outcomes in Ghana.

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Adiponectin accounts for gender differences in hepatocellular carcinoma incidence

Cited by 76 publications

References 33 publications

Nomogram based on inflammatory indices for differentiating intrahepatic cholangiocarcinoma from hepatocellular carcinoma

Nomogram based on inflammatory indices for differentiating intrahepatic cholangiocarcinoma from hepatocellular carcinoma

Sex disparities in presentation and prognosis of 1110 patients with hepatocellular carcinoma

Ambulatory end-stage liver disease in Ghana; patient profile and utility of alpha fetoprotein and aspartate aminotransferase - platelet ratio index.

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