AST/ALT-to-platelet ratio (AARPRI) predicts gynaecological cancers: a 8-years follow-up study in 653 women

Abstract

Non-alcoholic fatty liver disease (NAFLD), specifically liver steatosis and fibrosis with steatohepatitis (NASH), is often associated with visceral adiposopathy, whose pathogenetic features have been proposed as tumorigenic triggers. We performed a prospective analysis in 653 metabolic women to reveal any conditions that may predict and concur to cancer development during a 8-years period of follow-up. Among clinical and biochemical variables, only AST and non-invasive liver fibrosis scores (AARPRI, APRI, FIB-4, mFIB4) significantly distinguished cancer-developer women (n = 62, 9.5%) from those who did not develop cancer (p < 0.001). In ROC analysis, these scores also showed good sensitivity and specificity in differentiating women who developed cancer (all p < 0.001). We then calculated OR for these indexes finding that increased AARPRI was associated with the highest risk (OR = 6, p < 0.001) of gynaecological cancers development. We further validated these cut-off values in women who had developed other types of cancer, confirming that AARPRI is able to identify the risk for cancer development (OR = 5, p < 0.001). Our findings support the hypothesis that NAFLD, more than obesity per se, is directly associated with the clinical and pathogenic metabolic scenario of gynaecological cancers and encourage the use of liver fibrosis indexes to detect risk of cancer onset in women. Preventing adiposopathy and NAFLD through lifestyle and therapies may represent an instrumental strategy for cancer prevention and/or co-treatment in oncology.

Low Adherence to Mediterranean Diet Characterizes Metabolic Patients with Gastrointestinal Cancer

“…We have previously demonstrated the role of low HDL-c levels as a bona fide novel marker to predict the development of hepatocellular carcinoma (HCC) in subjects with non-alcoholic fatty liver disease, as well as the importance of a high WC for such development [ 36 ]. Moreover, we identified specific features of metabolic dysfunction-associated liver disease (MASLD) as markers of thyroid and gynecological cancer risk, highlighting the importance of non-invasive, serum-based biomarkers for the early detection of such conditions and the role of healthy lifestyles in their prevention [ 37 , 38 ].…”