| Title: | Aspirin and HCC risk in MASLD: Nationwide cohort study with genetic risk analysis |
| Journal: | Clinical and Molecular Hepatology |
| Published: | 25 Nov 2025 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/41287437/ |
| DOI: | https://doi.org/10.3350/cmh.2025.0528 |
| URL: | https://www.e-cmh.org/upload/pdf/cmh-2025-0528.pdf |
Publication 18787
WARNING: the interactive features of this website use CSS3, which your browser does not support. To use the full features of this website, please update your browser.
Abstract
BACKGROUND/AIMS: The association between aspirin use and hepatocellular carcinoma (HCC) risk in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) remains unclear. This study evaluated the effect of aspirin on HCC development in MASLD patients using Korean National Health Insurance Service (NHIS) and UK Biobank (UKB) databases.</p>
METHODS: A retrospective cohort analysis was conducted using the NHIS database with a 3-year landmark design. Baseline characteristics were balanced using inverse probability of treatment weighting (IPTW) and 1:3 propensity score matching (PSM). Additionally, Mendelian randomization analysis was performed in the UKB cohort using a genomic risk score (GRS) for salicylic acid, based on genetic variants related to aspirin metabolism, as a proxy for aspirin use.</p>
RESULTS: In the NHIS cohort, 6,584,155 eligible patients were included, of whom 1,723,435 had MASLD. After PSM, aspirin use was associated with a significantly lower risk of HCC compared to no aspirin use, in both the overall population (adjusted subdistribution hazard ratio [ASHR]=0.86; 95% confidence interval [CI] 0.78-0.95; P=0.002) and MASLD group (ASHR=0.86; 95% CI 0.75-0.99; P=0.036). Similar results were reproduced in the IPTW population and several sensitivity and subgroup analyses. In the UKB cohort, individuals in the top 95% of GRS had a significantly lower risk of HCC compared to those in the bottom 5%, in both the overall population (ASHR=0.61; 95% CI 0.39-0.95; P=0.028) and MASLD group (ASHR=0.47; 95% CI 0.29-0.76; P=0.002).</p>
CONCLUSIONS: Findings from both population-based and genetic analyses suggest a possible protective association between aspirin use and HCC in patients with MASLD, which warrants further validation.</p>
16 Keywords
- Adult
- Aged
- Aspirin
- Carcinoma, Hepatocellular
- Databases, Factual
- Fatty Liver
- Female
- Humans
- Liver Neoplasms
- Male
- Mendelian Randomization Analysis
- Middle Aged
- Polymorphism, Single Nucleotide
- Republic of Korea
- Retrospective Studies
- Risk Factors
14 Authors
- Juhee Ahn
- Moon Haeng Hur
- Hyunjae Shin
- Min Kyung Park
- Sungho Won
- Jeayeon Park
- Yunmi Ko
- Youngsu Park
- Yun Bin Lee
- Eun Ju Cho
- Jeong-Hoon Lee
- Su Jong Yu
- Jung-Hwan Yoon
- Yoon Jun Kim
1 Application
| Application ID | Title |
|---|---|
| 53799 | Impact of genetic and environmental factors on the health-related outcomes in chronic kidney disease patients |
Enabling scientific discoveries that improve human health