Association of NAFLD and Insulin Resistance with Non Metastatic Bladder Cancer Patients: A Cross-Sectional Retrospective Study

Abstract

Among risk factors (apart from smoking) likely involved in bladder cancer (BCa), metabolic syndrome (MS), obesity and type 2 diabetes mellitus (T2DM) have been explored with contrasting results. In spite of these studies, there is little data on the association between nonalcoholic fatty liver disease (NAFLD), its main driver, i.e., insulin resistance (IR), and BCa. Implanting a cross-sectional retrospective study we tried to investigate both NAFLD and IR prevalence in a hospital based population of BCa patients. We studied laboratory data from 204 patients with histologically confirmed non metastatic BCa and 50 subjects with no BCa, but with bladder diseases (no Ca BD). We evaluated the presence of NAFLD by the triglycerides/glucose Index (TyG Index), using a cut-off of 0.59 and by the Aspartate Aminotransferase/Alanine Aminotransferase AST/ALT ratio. IR was assessed by the same TyG Index (cut-off 4.68) and the triglycerides/High-Density Lipoprotein HDL ratio (cut-off 2.197). The diagnosis of impaired fasting glucose (IFG), condition of prediabetes, as well as that of T2DM was assessed according to canonical guidelines. The TyG Index predicted NAFLD presence in both groups (p = 0.000), but the BCa group showed a major percentage of NAFLD cases with respect to no Ca BD group (59% versus 40%). A greater proportion of IR (47%) in BCa group than in no Ca BD one (37%) was evidenced by the TyG Index with its median value significantly different (p = 0.0092). This high rate of IR in the BCa group was confirmed by the triglycerides/HDL ratio (p = 0.02). Prediabetes and T2DM were more prevalent in the BCa group than no Ca BD group (p = 0.024). In this study a consistent NAFLD presence was found in BCa patients. This is an important comorbidity factor that deserves further consideration in prospective studies. The higher prevalence of NAFLD, IR, prediabetes and T2DM in the BCa group evidences the need that these disorders should be reckoned as adjunct factors that could impact on this cancerous disease.

Association Between the Triglyceride–Glucose Index and Outcomes of Nonalcoholic Fatty Liver Disease: A Large-Scale Health Management Cohort Study

“… 22 Tarantino et al reported the TyG index predicted NAFLD presence in bladder cancer. 23 However, those studies focused on this relationship only in specific populations. Another cross-sectional study compared TyG and HOMA-IR as predictors of the prevalence of NAFLD, reporting that TyG is superior to HOMA as a NAFLD predictor and is also related to the severity of NAFLD in Korean adults.…”

Elevated De Ritis Ratio as a Predictor for Acute Kidney Injury after Radical Retropubic Prostatectomy

“…The De Ritis ratio was reported to be higher in patients with non-metastatic bladder cancer. [ 28 ] Furthermore, the De Ritis ratio has also been reported to be a significant prognostic indicator for testicular cancer, renal cell carcinoma, bladder cancer, pancreatic cancer, solid tumor, and oropharyngeal cancer [ 8 , 9 , 10 , 11 , 29 , 30 , 31 ]. In patients who have undergone radical cystectomy, an elevated De Ritis ratio is associated with overall survival and disease-specific survival [ 10 , 29 ].…”

Emerging Biomarkers for Predicting Bladder Cancer Lymph Node Metastasis

“…These factors may increase the risk of BCa recurrence and lead to a poor prognosis (121). Studies have shown that patients with BCa had higher insulin resistance than those without cancer but with bladder disease (122). DM was associated with elevated BCa or cancer mortality risk, especially in men (123).…”