Sex-specific Association Between Metabolic Syndrome Components and Liver Cancer Risk

Pavankumar Kamat


October 19, 2021


  • Individual metabolic syndrome (MetS) components showed a sex-specific linear or U-shaped association with the risk of liver cancer.

  • Central obesity and hyperglycaemia were linked to an increased risk of liver cancer in men.

Why this matters

  • Findings emphasise the significance of sex-specific liver cancer prevention strategies, particularly in patients with MetS.

Study design

  • A prospective cohort study included 474,929 participants (age, 40-69 years; 219,383 men; 256,276 women) without cancer from the UK Biobank (2006-2010).

  • Funding: Guangdong provincial Natural Science Fund project and others.

Key results

  • Of 474,929 participants, 276 incident cases of liver cancer (175 men; 101 women) were reported over a median follow-up of 6.6 years.

  • Compared with women, the risk of liver cancer was higher in men with (adjusted HR [aHR]; 95% CI):

    • MetS (1.48; 1.27-1.72; P<.001);

    • central obesity (1.62; 1.16-2.27; P<.01); and

    • hyperglycaemia:

      • pre-diabetes (1.70; 1.22-2.59; P<.05); and

      • diabetes (2.88; 1.91-4.34; P<.001).

  • High waist circumference (WC) and blood glucose had a dose-dependent association with an increased risk of liver cancer in both genders (aHR; 95% CI):

    • WC:

      • women (1.02; 1.01-1.03); and

      • men (1.02; 1.00-1.04; Pinteraction=.71).

    • blood glucose:

      • women (1.09; 0.95-1.26); and

      • men (1.19; 1.12-1.26; Pinteraction=.13).

  • U-shaped associations were seen between high-density lipoprotein (HDL) cholesterol and liver cancer in both genders and between blood pressure and liver cancer in women.

  • Low HDL cholesterol (<1.35 mmol/L) in men and high HDL cholesterol (>1.52 mmol/L) in women were associated with a higher risk of liver cancer.


  • Observational design.


Xia B, Peng J, Enrico T, Lu K, Cheung EC, Kuo Z, He Q, Tang Y, Liu A, Fan D, Zhang C, He Y, Pan Y, Yuan J. Metabolic syndrome and its component traits present gender-specific association with liver cancer risk: a prospective cohort study. BMC Cancer. 2021;21(1):1084. doi: 10.1186/s12885-021-08760-1. PMID: 34620113  View full text

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.


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