Clinical and Molecular Hepatology

"Won Sohn"

Special Issue

Steatotic liver disease

KASL clinical practice guidelines for the management of metabolic dysfunction-associated steatotic liver disease 2025: Won Sohn, Young-Sun Lee, Soon Sun Kim, Jung Hee Kim, Young-Joo Jin, Gi-Ae Kim, Pil Soo Sung, Jeong-Ju Yoo, Young Chang, Eun Joo Lee, Hye Won Lee, Miyoung Choi, Su Jong Yu, Young Kul Jung, Byoung Kuk Jang, on behalf of The Korean Association for the Study of the Liver (KASL); Clin Mol Hepatol 2025;31(Suppl):S1-S31.
Published online February 19, 2025; DOI: https://doi.org/10.3350/cmh.2025.0045

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Metabolic Dysfunction-Associated Steatotic Liver Disease, Recent Revision of Terminology and Its Implications
Hyo Young Lee, Eileen L. Yoon
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Rui-Qi Ye, Yi-Fan Chen, Chang Ma, Xi Cheng, Wei Guo, Sha Li
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A Case Report of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) with Improved Cardiometabolic Risk Factors Following Treatment with Saenggangunbi-tang
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The Journal of Internal Korean Medicine.2025; 46(2): 303. CrossRef
Food Nutrients and Bioactive Compounds for Managing Metabolic Dysfunction-Associated Steatotic Liver Disease: A Comprehensive Review
Erdenetsogt Dungubat, Kohei Fujikura, Masahiko Kuroda, Toshio Fukusato, Yoshihisa Takahashi
Nutrients.2025; 17(13): 2211. CrossRef
Associations between steatotic liver disease subtypes and incident atrial fibrillation in young adults: a nationwide cohort study
Jeayeon Park, Goh Eun Chung, Su Jong Yu, Yoon Jun Kim, Jung-Hwan Yoon, Kyungdo Han, Eun Ju Cho
Cardiovascular Diabetology.2025;[Epub] CrossRef
Second-line antidiabetic drugs: friend or foe of the liver
Jiwon Yang, Gunho Kim, Ju Hyun Shim, Jihyun An
Journal of Liver Cancer.2025; 25(2): 187. CrossRef
Extrahepatic manifestation of metabolic dysfunction-associated steatotic liver disease
Anoushka Shenoy, Aijaz Ahmed, Donghee Kim
Metabolism and Target Organ Damage.2025;[Epub] CrossRef
2025 Clinical Practice Guidelines for Diabetes: Management of Metabolic Dysfunction-Associated Steatotic Liver Disease
Jaehyun Bae
The Journal of Korean Diabetes.2025; 26(3): 172. CrossRef
Paired snRNA-seq and scRNA-seq analysis of MASLD patients to identify early-stage markers for disease progression
Suebin Park, Su-Hyeon Lee, Se-eun Han, Beom Kyung Kim, Byungjin Hwang
Hepatology Communications.2025;[Epub] CrossRef
Sex Hormones and Metabolic Dysfunction-Associated Steatotic Liver Disease
Ralf Weiskirchen, Amedeo Lonardo
International Journal of Molecular Sciences.2025; 26(19): 9594. CrossRef
Discovery of ultrasound-derived fat fraction as a non-invasive tool for MASLD diagnosis
Huiru Jin, Mengfan Jiao, Chengxiao Yu, Tingting Ren, Qingling Chen, Zixing Dai, Erfu Xie, Longfeng Jiang, Yuwen Li
European Journal of Medical Research.2025;[Epub] CrossRef
Risk of Esophageal and Gastric Cancer by Histologic Subtype in Steatotic Liver Disease: A UK Biobank Study
Donghoon Kang, Ji Won Han, Kenneth R. Muir, Artitaya Lophatananon, Jongin Lee
Cancers.2025; 17(21): 3416. CrossRef

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Editorials

Steatotic liver disease

Essential tools for assessing advanced fibrosis in metabolic dysfunction-associated steatotic liver disease: Editorial on “Optimal cut-offs of vibration-controlled transient elastography and magnetic resonance elastography in diagnosing advanced liver fibrosis in patients with nonalcoholic fatty liver disease: A systematic review and meta-analysis”: Won Sohn; Clin Mol Hepatol 2025;31(1):277-280.
Published online October 11, 2024; DOI: https://doi.org/10.3350/cmh.2024.0823

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Correspondence to editorial on “Optimal cut-offs of vibration-controlled transient elastography and magnetic resonance elastography in diagnosing advanced liver fibrosis in patients with nonalcoholic fatty liver disease: a systematic review and meta-analy
Young Eun Chon, Jung Hwan Yu, Seung Up Kim
Clinical and Molecular Hepatology.2025; 31(1): e61. CrossRef
Impact of Short-Term Liraglutide Therapy on Non-Invasive Markers of Liver Fibrosis in Patients with MASLD
Aleksandra Bołdys, Maciej Borówka, Łukasz Bułdak, Bogusław Okopień
Metabolites.2025; 15(8): 510. CrossRef
Liver Fibrosis and the Risk of Coronary Artery Disease, Stent Thrombosis, Restenosis and Adverse Clinical Outcomes
Na Tian, Tie Xiao, Tianyi Xia, Hai‐Yang Yuan, Michael D. Shapiro, Gregory Y. H. Lip, Cheng‐Han Fanren, Li‐You Lian, Chen‐Xiao Huang, Yi‐Xuan Wei, Giovanni Targher, Christopher D. Byrne, Cheng‐Lv Hong, Shenghong Ju, Ming‐Hua Zheng
Alimentary Pharmacology & Therapeutics.2025;[Epub] CrossRef

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3 Web of Science
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Steatotic liver disease

The growing burden of non-alcoholic fatty liver disease on mortality: Ju-Yeon Cho, Won Sohn; Clin Mol Hepatol 2023;29(2):374-376.
Published online March 6, 2023; DOI: https://doi.org/10.3350/cmh.2023.0084

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A landscape of liver cirrhosis and transplantation in Mexico: Changing leading causes and transplant as response
Icela Palma-Lara, María Guadalupe Ortiz-López, José Bonilla-Delgado, Juanita Pérez-Escobar, Ricardo Godínez-Aguilar, Claudia Luévano-Contreras, Ana María Espinosa-García, Javier Pérez-Durán, Patricia García Alonso-Themann, Manuel Nolasco-Quiroga, Javier F
Annals of Hepatology.2025; 30(1): 101562. CrossRef
Essential tools for assessing advanced fibrosis in metabolic dysfunction-associated steatotic liver disease: Editorial on “Optimal cut-offs of vibration-controlled transient elastography and magnetic resonance elastography in diagnosing advanced liver fib
Won Sohn
Clinical and Molecular Hepatology.2025; 31(1): 277. CrossRef
Therapeutic Potential of GLP-1 Receptor Agonists in Metabolic Associated Steatotic Liver Disease
Klaudia Nowak, Krzysztof Łupina, Anna Romac, Aleksandra Kalisz, Łucja Ilkiewicz, Jakub Janczura
Annals of Pharmacotherapy.2025; 59(10): 928. CrossRef
Hepatoprotective activity of mulberry extract in NAFLD mice for regulating lipid metabolism and inflammation identified via AMPK/PPAR-γ/NF-κB axis
Li-juan Zhang, Shun-ying Li, Shao-li Fan, Aobulikasimu nuerbiye, Jiu-yang Zhao, Bahetiyaer Keremu, Lu Yang, Ke Zhang, Hang-yu Wang, Jin-hui Wang
Journal of Ethnopharmacology.2025; 351: 120108. CrossRef
Non-alcoholic fatty liver disease versus cirrhosis in rotator cuff repair: Differential risks and complication profiles in a matched national cohort
Catherine Hand, Jared Sasaki, Camden Bohn, Francis Hand, Kyleen Jan, Daniel Shinn, Brian Forsythe
Journal of Orthopaedics.2025; 69: 244. CrossRef
A New Korean Nomenclature for Steatotic Liver Disease

The Korean Journal of Medicine.2024; 99(4): 189. CrossRef
A New Korean Nomenclature for Steatotic Liver Disease

The Korean Journal of Gastroenterology.2024; 84(1): 1. CrossRef
A New Korean Nomenclature for Steatotic Liver Disease

Gut and Liver.2024; 18(5): 924. CrossRef
A new Korean nomenclature for steatotic liver disease

Clinical and Molecular Hepatology.2024; 30(Suppl): S214. CrossRef

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Review

Steatotic liver disease

The effects of moderate alcohol consumption on non-alcoholic fatty liver disease: Hyunwoo Oh, Won Sohn, Yong Kyun Cho; Clin Mol Hepatol 2023;29(Suppl):S261-S267.
Published online December 22, 2022; DOI: https://doi.org/10.3350/cmh.2022.0393

Abstract
PDF

Non-alcoholic fatty liver disease (NAFLD) is accepted as a counterpart to alcohol-related liver disease because it is defined as hepatic steatosis without excessive use of alcohol. However, the definition of moderate alcohol consumption, as well as whether moderate alcohol consumption is beneficial or detrimental, remains controversial. In this review, the findings of clinical studies to date with high-quality evidence regarding the effects of moderate alcohol consumption in NAFLD patients were compared and summarized.

Citations

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Effects of moderate beer consumption on immunity and the gut microbiome in immunosuppressed mice
Shumin HU, Hua YIN, Xiaxia LI, Minghao FAN, Huajun LI
Bioscience of Microbiota, Food and Health.2025; 44(1): 32. CrossRef
Changes in drinking levels and metabolic dysfunction-associated steatotic liver disease: a longitudinal study from the China multi-ethnic cohort study
Ning Zhang, Jingzhong Li, Xiaofen Xie, Yifan Hu, Hongxiang Chen, Yuan Zhang, Yujie Liu, Xingren Zhu, Hao Xu, Zhenghong Wang, Kangzhuo Baima, Xuehui Zhang, Zixiu Qin, Zhimiao Yu, Xiong Xiao, Xing Zhao
BMC Public Health.2025;[Epub] CrossRef
Alcohol-associated liver disease: Natural history, management and novel targeted therapies
Edilmar Alvarado-Tapias, Elisa Pose, Jordi Gratacós-Ginès, Ana Clemente-Sánchez, Hugo López-Pelayo, Ramón Bataller
Clinical and Molecular Hepatology.2025; 31(Suppl): S112. CrossRef
Current Therapeutic Landscape for Metabolic Dysfunction-Associated Steatohepatitis
Arun George Devasia, Adaikalavan Ramasamy, Chen Huei Leo
International Journal of Molecular Sciences.2025; 26(4): 1778. CrossRef
Association between alcohol consumption and hepatic fibrosis in Chinese adult males with metabolic dysfunction-associated steatotic liver disease
Mao Li, Bin Yu, Xiaoli Zhang, Jia Pan, Lei Tang, Yi Zhang, Ruixin Wang, Honglian Zeng, Shujuan Yang
Frontiers in Medicine.2025;[Epub] CrossRef
Metabolic Impact of Alcohol Consumption in MASLD: Understanding MetALD and Beyond
Eva Juárez-Hernández, Montserrat Berrospe-Alfaro, Misael Uribe, Iván López-Mendez
Journal of Clinical and Experimental Hepatology.2025; 15(6): 103114. CrossRef
Alcohol-Induced Oxidative Stress and Gut–Liver–Brain Crosstalk: Expanding the Paradigm from ALD to MetALD
Jeong-Yoon Lee, Young-Min Jee, Keungmo Yang, Tom Ryu
Antioxidants.2025; 14(10): 1196. CrossRef
Risk of Hepatocellular Carcinoma by Steatotic Liver Disease and Its Newly Proposed Subclassification
Byeong Geun Song, Aryoung Kim, Myung Ji Goh, Wonseok Kang, Geum-Youn Gwak, Yong-Han Paik, Moon Seok Choi, Joon Hyeok Lee, Dong Hyun Sinn
Liver Cancer.2024; 13(5): 561. CrossRef
Metabolic dysfunction‐associated steatotic liver disease and MetALD increases the risk of liver cancer and gastrointestinal cancer: A nationwide cohort study
Yewan Park, Jooyi Jung, Seungbong Han, Gi‐Ae Kim
Alimentary Pharmacology & Therapeutics.2024; 60(11-12): 1599. CrossRef
Alcohol consumption and its association with cancer, cardiovascular, liver and brain diseases: a systematic review of Mendelian randomization studies
Naouras Bouajila, Cloé Domenighetti, Henri-Jean Aubin, Mickael Naassila
Frontiers in Epidemiology.2024;[Epub] CrossRef
The effect of moderate alcohol consumption on nonalcoholic fatty liver disease
Ji-Won Park, Ki Tae Suk
Clinical and Molecular Hepatology.2023; 29(2): 408. CrossRef
Oxidative balance score is inversely associated with the incidence of non-alcoholic fatty liver disease
A-Ra Cho, Yu-Jin Kwon, Jun-Hyuk Lee
Clinical Nutrition.2023; 42(8): 1292. CrossRef
Multi-system diseases and death trajectory of metabolic dysfunction-associated fatty liver disease: findings from the UK Biobank
Yu Jia, Dongze Li, Yi You, Jing Yu, Wenli Jiang, Yi Liu, Rui Zeng, Zhi Wan, Yi Lei, Xiaoyang Liao
BMC Medicine.2023;[Epub] CrossRef
Alcohol consumption and the risk of liver disease: a nationwide, population-based study
Sang Yi Moon, Minkook Son, Yeo Wool Kang, Myeongseok Koh, Jong Yoon Lee, Yang Hyun Baek
Frontiers in Medicine.2023;[Epub] CrossRef

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Correspondence

Hepatic neoplasm

Correspondence on Editorial regarding “Impact of nationwide hepatocellular carcinoma surveillance on the prognosis in patients with chronic liver disease”: Won Sohn, Yong-Han Paik; Clin Mol Hepatol 2023;29(1):182-184.
Published online November 22, 2022; DOI: https://doi.org/10.3350/cmh.2022.0411

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Citations to this article as recorded by

Correspondence to editorial on “Multiomics profiling of buffy coat and plasma unveils etiology-specific signatures in hepatocellular carcinoma”
Su Bin Lim, Hyo Jung Cho
Clinical and Molecular Hepatology.2024; 30(4): 1009. CrossRef

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55 Download
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Original Articles

Impact of nationwide hepatocellular carcinoma surveillance on the prognosis in patients with chronic liver disease: Won Sohn, Danbee Kang, Minwoong Kang, Eliseo Guallar, Juhee Cho, Yong-Han Paik; Clin Mol Hepatol 2022;28(4):851-863.
Published online June 3, 2022; DOI: https://doi.org/10.3350/cmh.2022.0037

Background/Aims
This study aimed to investigate the effect of hepatocellular carcinoma (HCC) surveillance using the Korea National Liver Cancer Screening Program on the receipt of curative treatment for HCC and mortality in patients with chronic liver disease.
Methods
This population-based cohort study from the Korean National Health Insurance Service included 2003 to 2015 claims data collected from 1,209,825 patients aged ≥40 years with chronic hepatitis B, chronic hepatitis C, and liver cirrhosis. Patients were divided according to HCC surveillance using ultrasonography and serum alpha-fetoprotein every 6–12 months. The study outcomes were the receipt of curative treatment (surgical resection, radiofrequency ablation, or liver transplantation) and all-cause mortality.
Results
The study population consisted of 1,209,825 patients with chronic hepatitis B, chronic hepatitis C, and liver cirrhosis (median age, 52.0 years; interquartile range, 46–55 years; 683,902 men [56.5%]). The proportion of participants who underwent HCC surveillance was 52.7% (n=657,889). During 10,522,940 person-years of follow-up, 74,433 HCC cases developed, including 36,006 patients who underwent curative treatment. The surveillance group had a significantly higher proportion of curative treatment for HCC than the non-surveillance group after adjusting for confounding factors (adjusted hazard ratio [HR], 5.64; 95% confidence interval [CI], 5.48–5.81). The surveillance group had a significantly lower mortality rate than the non-surveillance group (adjusted HR, 0.56; 95% CI, 0.55–0.56).
Conclusions
HCC surveillance using the national screening program in patients with chronic viral hepatitis or liver cirrhosis provides better opportunity for curative treatment for HCC and improves overall survival.

Citations

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Treatment patterns and clinical outcomes of patients with hepatocellular carcinoma—a cohort study of 1020 patients in Sweden
Bonnie Bengtsson, Linnea Widman, Per Stål, Hannes Hagström
Scandinavian Journal of Gastroenterology.2025; 60(10): 1023. CrossRef
Contrasting associations of body mass index and waist circumference with cancer incidence in the elderly: a nationwide population-based study
Soo Yeon Jang, Minwoong Kang, Eyun Song, Ahreum Jang, Min Jeong Park, Kyung Mook Choi, Sei Hyun Baik, Hye Jin Yoo
Frontiers in Oncology.2025;[Epub] CrossRef
Public health strategies for hepatocellular carcinoma: from risk factors to prevention and control
Mei-Hsuan Lee
Journal of Liver Cancer.2025; 25(2): 204. CrossRef
Performance of the multi-target hepatocellular carcinoma blood test: Design and rationale of the ALTUS study
Binu V. John, Mark Camardo, Kyle Porter, Paul Z. Elias, Elle Kielar-Grevstad, Seema P. Rego, Neehar D. Parikh, Lewis R. Roberts, Alvin C. Silva, Amit G. Singal, Ju Dong Yang, Paul J. Limburg
Hepatology Communications.2025;[Epub] CrossRef
PAGE-B incorporating moderate HBV DNA levels predicts risk of HCC among patients entering into HBeAg-positive chronic hepatitis B
Ho Soo Chun, George V. Papatheodoridis, Minjong Lee, Hye Ah Lee, Yeong Hwa Kim, Seo Hyun Kim, Yun-Seo Oh, Su Jin Park, Jihye Kim, Han Ah Lee, Hwi Young Kim, Tae Hun Kim, Eileen L. Yoon, Dae Won Jun, Sang Hoon Ahn, Vana Sypsa, Cihan Yurdaydin, Pietro Lampe
Journal of Hepatology.2024; 80(1): 20. CrossRef
Changes in the ultrasound presentation of hepatocellular carcinoma: a center’s three decades of experience
Lydia Giannitrapani, Simona Amodeo, Luigi Mirarchi, Antonino Terranova, Aurelio Seidita, Chiara Mozzini, Daniela Cabibi, Giuseppe Brancatelli, Anna Licata, Maurizio Soresi
Journal of Ultrasound.2024; 27(2): 383. CrossRef
Synthesis of Ag-Loaded ZnCo₂O₄ Hierarchical Nanospheres With Improved Isoprene Sensitivity
Xueling Wang, Xuping Li, Yanwei Li, Guang Sun, Jianliang Cao, Yan Wang
IEEE Sensors Journal.2024; 24(11): 18288. CrossRef
Recent Hepatocellular Carcinoma Managements in Korea: Focus on the Updated Guidelines in 2022
Yuri Cho, Bo Hyun Kim, Young-Suk Lim
Digestive Disease Interventions.2024; 08(03): 169. CrossRef
Association of physical activity, including amount and maintenance, with the risk of HCC among patients with type 2 diabetes
Wonkyung Han, Kyungdo Han, Seong Gyu Hwang, Sang Hoon Ahn, Mi Na Kim
JHEP Reports.2024; 6(10): 101166. CrossRef
Multiomics profiling of buffy coat and plasma unveils etiology-specific signatures in hepatocellular carcinoma
Jiwon Hong, Jung Woo Eun, Geum Ok Baek, Jae Youn Cheong, Seryoung Park, Soon Sun Kim, Hyo Jung Cho, Su Bin Lim
Clinical and Molecular Hepatology.2024; 30(3): 360. CrossRef
Evolving trends in treatment patterns for hepatocellular carcinoma in Korea from 2008 to 2022: a nationwide population-based study
Ji Won Han, Won Sohn, Gwang Hyeon Choi, Jeong Won Jang, Gi Hyeon Seo, Bo Hyun Kim, Jong Young Choi
Journal of Liver Cancer.2024; 24(2): 274. CrossRef
Correspondence on Editorial regarding “Impact of nationwide hepatocellular carcinoma surveillance on the prognosis in patients with chronic liver disease”
Won Sohn, Yong-Han Paik
Clinical and Molecular Hepatology.2023; 29(1): 182. CrossRef
Cost-effectiveness of expanded antiviral treatment for chronic hepatitis B virus infection in China: an economic evaluation
Sihui Zhang, Chao Wang, Bei Liu, Qing-Bin Lu, Jia Shang, Yihua Zhou, Jidong Jia, Xiaoyuan Xu, Huiying Rao, Bingfeng Han, Tianshuo Zhao, Linyi Chen, Mingzhu Xie, Jiahao Cui, Juan Du, Jing zeng, Ninghua huang, Yaqiong Liu, Lei Zhang, Hui Zhuang, Fuqiang Cui
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Hao-dan Mao, Shu-qin Zheng, Su-hua Yang, Ze-yu Huang, Yuan Xue, Min Zhou
PeerJ.2023; 11: e15014. CrossRef
Clinical practice guidelines and real-world practice for hepatocellular carcinoma in Taiwan: Bridging the gap
Shen-Yung Wang
Clinical and Molecular Hepatology.2023; 29(2): 349. CrossRef
The clinical management of hepatocellular carcinoma in China: Progress and challenges
Shan Shan, Jidong Jia
Clinical and Molecular Hepatology.2023; 29(2): 339. CrossRef
The prime time for management of hepatocellular carcinoma in Hong Kong
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Clinical and Molecular Hepatology.2023; 29(2): 345. CrossRef
What should be done to reduce the discrepancy between guidelines and real-life practice for hepatocellular carcinoma in Korea?
Min Kyung Park, Yoon Jun Kim
Clinical and Molecular Hepatology.2023; 29(2): 332. CrossRef
Clinical practice guideline and real-life practice in hepatocellular carcinoma: A Korean perspective
Myung Ji Goh, Dong Hyun Sinn, Jong Man Kim, Min Woo Lee, Dong Ho Hyun, Jeong Il Yu, Jung Yong Hong, Moon Seok Choi
Clinical and Molecular Hepatology.2023; 29(2): 197. CrossRef
Clinical practice guidelines and real-life practice in hepatocellular carcinoma: A Taiwan perspective
Tung-Hung Su, Chih-Horng Wu, Tsung-Hao Liu, Cheng-Maw Ho, Chun-Jen Liu
Clinical and Molecular Hepatology.2023; 29(2): 230. CrossRef
Establishment and application of a survival rate graph model based on biomarkers and imaging indexes after primary hepatocellular carcinoma resection
Yue Xu, Xiaoqin Yao, Jinmei Li, Guoyuan Zhang, Guangcheng Luo, Qiang Wang
Cancer Medicine.2023; 12(12): 13329. CrossRef
Prediction model of hepatitis B virus-related hepatocellular carcinoma in patients receiving antiviral therapy
Beom Kyung Kim, Sang Hoon Ahn
Journal of the Formosan Medical Association.2023; 122(12): 1238. CrossRef
A machine learning model for predicting hepatocellular carcinoma risk in patients with chronic hepatitis B
Hye Won Lee, Hwiyoung Kim, Taeyun Park, Soo Young Park, Young Eun Chon, Yeon Seok Seo, Jae Seung Lee, Jun Yong park, Do Young Kim, Sang Hoon Ahn, Beom Kyung Kim, Seung Up Kim
Liver International.2023; 43(8): 1813. CrossRef
Risk factors associated with late hepatocellular carcinoma detection in patients undergoing regular surveillance
Sangmi Jang, Young-Joo Jin, Jin-Woo Lee, Dam Kwon, Jung Hwan Yu
Medicine.2023; 102(32): e34637. CrossRef
Surveillance for hepatocellular carcinoma: It is time to move forward
Bo Hyun Kim, Yuri Cho, Joong-Won Park
Clinical and Molecular Hepatology.2022; 28(4): 810. CrossRef
Suboptimal Performance of Hepatocellular Carcinoma Prediction Models in Patients with Hepatitis B Virus-Related Cirrhosis
Jae Lee, Tae Lim, Hye Lee, Seung Kim, Jun Park, Do Kim, Sang Ahn, Hyun Lee, Jung Lee, Ja Kim, In Min, Beom Kim
Diagnostics.2022; 13(1): 3. CrossRef

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Hepatic neoplasm

Obesity and the risk of primary liver cancer: A systematic review and meta-analysis: Won Sohn, Hyun Woong Lee, Sangheun Lee, Jin Hong Lim, Min Woo Lee, Chan Hyuk Park, Seung Kew Yoon; Clin Mol Hepatol 2021;27(1):157-174.
Published online November 26, 2020; DOI: https://doi.org/10.3350/cmh.2020.0176

Background/Aims
In this systematic review and meta-analysis, we aimed to clarify the effect of obesity on the occurrence of and mortality from primary liver cancer.
Methods
This study was conducted using a systematic literature search of MEDLINE, EMBASE, and the Cochrane Library until November 2018 using the primary keywords “obesity,” “overweight,” “body mass index (BMI),” “body weight,” “liver,” “cancer,” “hepatocellular carcinoma,” “liver cancer,” “risk,” and “mortality.” Studies assessing the relationship between BMI and occurrence of or mortality from primary liver cancer in prospective cohorts and those reporting hazard ratios (HRs) or data that allow HR estimation were included.
Results
A total of 28 prospective cohort studies with 8,135,906 subjects were included in the final analysis. These included 22 studies with 6,059,561 subjects for cancer occurrence and seven studies with 2,077,425 subjects for cancerrelated mortality. In the meta-analysis, an increase in BMI was associated with the occurrence of primary liver cancer (HR, 1.69; 95% confidence interval, 1.50–1.90, I²=56%). A BMI-dependent increase in the risk of occurrence of primary liver cancer was reported. HRs were 1.36 (95% CI, 1.02–1.81), 1.77 (95% CI, 1.56–2.01), and 3.08 (95% CI, 1.21–7.86) for BMI >25 kg/m², >30 kg/m², and >35 kg/m², respectively. Furthermore, increased BMI resulted in enhanced liver cancer-related mortality (HR, 1.61; 95% CI, 1.14–2.27, I²=80%).
Conclusions
High BMI increases liver cancer mortality and occurrence of primary liver cancer. Obesity is an independent risk factor for the occurrence of and mortality from primary liver cancer.

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Special topic: Alcoholic liver diseases
The 14th International Symposium on Alcoholic Liver and Pancreatic Diseases and Cirrhosis (ISALPDC)

Alcohol-related liver disease

The effect of moderate alcohol drinking in nonalcoholic fatty liver disease: Jong Hwa Choi, Won Sohn, Yong Kyun Cho; Clin Mol Hepatol 2020;26(4):662-669.
Published online September 25, 2020; DOI: https://doi.org/10.3350/cmh.2020.0163

Abstract
PDF

Nonalcoholic fatty liver disease (NAFLD) is defined by fat accumulation in liver that is not caused by excessive alcohol consumption. Safe limits of alcohol consumption in NAFLD are usually defined as alcohol consumption of less than 210 g per week for men and 140 g per week for women (30 g/day in men, 20 g/day in women) and alcohol consumption below safe limits is generally regarded as moderate alcohol consumption. Many studies have investigated the effects of moderate alcohol consumption on NAFLD patients. Some studies showed that moderate alcohol consumption prevented the progression of fibrosis in the liver, whereas other reports showed worsening of fibrosis in the liver based on serologic, radiologic and liver biopsy findings compared with effects on total abstainers. NAFLD is also thought to be a hepatic manifestation of metabolic syndrome, and when combined with excessive alcohol consumption results in the development of components of metabolic syndrome and systemic harmful effects. The effects of moderate alcohol consumption on NAFLD have yet to be established.

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Original Articles

Hepatic neoplasm

Risk score model for the development of hepatocellular carcinoma in treatment-naïve patients receiving oral antiviral treatment for chronic hepatitis B: Won Sohn, Ju-Yeon Cho, Ji Hoon Kim, Jung Il Lee, Hyung Joon Kim, Min-Ah Woo, Sin-Ho Jung, Yong-Han Paik; Clin Mol Hepatol 2017;23(2):170-178.
Published online May 16, 2017; DOI: https://doi.org/10.3350/cmh.2016.0086

Background/Aims
This study aimed to develop and validate a risk prediction model for the development of hepatocellular carcinoma (HCC) in treatment-naïve patients receiving oral antiviral treatment for chronic hepatitis B (CHB).
Methods
We investigated 2,061 Korean treatment-naïve patients with CHB treated with entecavir as an initial therapy. A risk score model for HCC development was developed based on multivariable Cox regression model in a single center (n=990) and was validated using the time-dependent area under the receiver operating characteristic curve (AUROC) in three other centers (n=1,071). The difference of HCC development among risk groups (low, intermediate, and high) categorized by risk score was also investigated.
Results
The cumulative incidence rates of HCC at 5 years were 11.2% and 8.9% in the testing and validation cohorts, respectively. HCC-Risk Estimating Score in CHB patients Under Entecavir (HCC-RESCUE) is formulated as (age+15×gender [female=0 / male=1]+23×cirrhosis [absence=0 / presence=1]). The AUROCs at 1 year, 3 years, and 5 years were 0.82, 0.81, and 0.81, respectively, in the validation cohort. A significant difference of HCC development in each risk group was determined by the 5-year HCC risk score in the validation cohort (low risk group, 2.1%; intermediate risk group, 9.3%; high risk group, 41.2%, p<0.001).
Conclusions
The study presents a new risk score model with a good ability to predict HCC development and determine high risk patients for HCC development consisting of readily available clinical factors in treatment-naïve CHB patients receiving entecavir.

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Hepatic neoplasm

Clinical significance and predictive factors of early massive recurrence after radiofrequency ablation in patients with a single small hepatocellular carcinoma: Ju-Yeon Cho, Moon Seok Choi, Gil Sun Lee, Won Sohn, Jemma Ahn, Dong-Hyun Sinn, Geum-Youn Gwak, Yong-Han Paik, Joon Hyeok Lee, Kwang Cheol Koh, Seung Woon Paik; Clin Mol Hepatol 2016;22(4):477-486.
Published online December 25, 2016; DOI: https://doi.org/10.3350/cmh.2016.0048

Abstract
PDF

Background/Aims
Radiofrequency ablation (RFA) is one of the most frequently applied curative treatments in patients with a single small hepatocellular carcinoma (HCC). However, the clinical significance of and risk factors for early massive recurrence after RFA—a dreadful event limiting further curative treatment—have not been fully evaluated.
Methods
In total, 438 patients with a single HCC of size ≤3 cm who underwent percutaneous RFA as an initial treatment between 2006 and 2009 were included. Baseline patient characteristics, overall survival, predictive factors, and recurrence after RFA were evaluated. In addition, the incidence, impact on survival, and predictive factors of early massive recurrence, and initial recurrence beyond the Milan criteria within 2 years were also investigated.
Results
During the median follow-up of 68.4 months, recurrent HCC was confirmed in 302 (68.9%) patients, with early massive recurrence in 27 patients (6.2%). The 1-, 3-, and 5-year overall survival rates were 95.4%, 84.7%, and 81.8%, respectively, in patients with no recurrence, 99.6%, 86.4%, and 70.1% in patients with recurrence within the Milan criteria or late recurrence, and 92.6%, 46.5%, and 0.05% in patients with early massive recurrence. Multivariable analysis identified older age, Child-Pugh score B or C, and early massive recurrence as predictive of poor overall survival. A tumor size of ≥2 cm and tumor location adjacent to the colon were independent risk factors predictive of early massive recurrence.
Conclusions
Early massive recurrence is independently predictive of poor overall survival after RFA in patients with a single small HCC. Tumors sized ≥2 cm and located adjacent to the colon appear to be independent risk factors for early massive recurrence.

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Hepatic neoplasm

Obesity and hepatocellular carcinoma in patients receiving entecavir for chronic hepatitis B: Jaemin Lee, Sun Hong Yoo, Won Sohn, Hyung Woo Kim, Yong Sun Choi, Jung Ho Won, Jin Young Heo, Sang Jong Park, Young Min Park; Clin Mol Hepatol 2016;22(3):339-349.
Published online September 25, 2016; DOI: https://doi.org/10.3350/cmh.2016.0021

Abstract
PDF

Background/Aims
This study aimed to clarify the effect of obesity on the development of hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) patients receiving antiviral treatment.
Methods
This study applied a retrospective analysis to a historical cohort in Bundang Jesaeng Hospital. In total, 102 CHB patients were treated with entecavir as an initial treatment for CHB and checked for obesity using a body composition analyzer. Hepatic steatosis was measured semiquantitatively using Hamaguchi’s scoring system in ultrasonography. Risk factors for the development of HCC were analyzed, including obesity-related factors (body mass index [BMI], waist circumference [WC], waist-to-hip ratio [WHR], visceral fat area [VFA], and hepatic steatosis).
Results
The median follow-up duration of the patients was 45.2 months (interquartile range: 36.0-58.3 months). The cumulative incidence rates of HCC at 1 year, 3 years, and 5 years were 0%, 5.3%, and 9.0%, respectively. Univariable analysis revealed that the risk factors for HCC development were a platelet count of <120,000 /mm² (hazard ratio [HR]=5.21, P=0.031), HBeAg negativity (HR=5.61, P=0.039), and liver cirrhosis (HR=10.26, P=0.031). Multivariable analysis showed that the significant risk factor for HCC development was liver cirrhosis (HR=9.07, P=0.042). However, none of the obesity-related risk factors were significantly associated with HCC: BMI ≥25 kg/m² (HR=0.90, P=0.894), WC ≥90 cm (HR=1.10, P=0.912), WHR ≥0.9 (HR=1.94, P=0.386), VFA ≥100 cm² (HR=1.69, P=0.495), and hepatic steatosis (HR=0.57, P=0.602).
Conclusions
HCC development is associated with liver cirrhosis but not obesity-related factors in CHB patients receiving entecavir.

Citations

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Hwang Sik Shin, Baek Gyu Jun, Sang-Wook Yi
Clinical and Molecular Hepatology.2022; 28(4): 773. CrossRef
Ginseng Consumption Possible Effect on Liver Cancer: A Meta-Analysis
Chenhong Zhu, Jingyi Wang, Weinan Liu, Lei Chen, Mohamed EA Abdelrahim, Liping Ren
Nutrition and Cancer.2021; 73(9): 1581. CrossRef
Risk factors for the development of hepatocellular carcinoma (HCC) in chronic hepatitis B virus (HBV) infection: a systematic review and meta‐analysis
Cori Campbell, Tingyan Wang, Anna L. McNaughton, Eleanor Barnes, Philippa C. Matthews
Journal of Viral Hepatitis.2021; 28(3): 493. CrossRef
Abnormal Metabolism in the Progression of Nonalcoholic Fatty Liver Disease to Hepatocellular Carcinoma: Mechanistic Insights to Chemoprevention
Danny Orabi, Nathan A. Berger, J. Mark Brown
Cancers.2021; 13(14): 3473. CrossRef
Relationship Between Platelet to White Blood Cell Ratio and 30-Day Prognosis of Patients with Acute-on-Chronic Liver Failure
Xiang Xu, Chen Li, Jing Chen, Xiaoyan Liu, Haibin Su, Jingjing Tong, Jinhua Hu
Hepatitis Monthly.2021;[Epub] CrossRef
Association of aspirin therapy with risk of hepatocellular carcinoma: A systematic review and dose-response analysis of cohort studies with 2.5 million participants
Shuijing Wang, Yan Yu, Paul M. Ryan, Minyan Dang, Cain Clark, Vasileios Kontogiannis, Jamal Rahmani, Hamed Kord Varkaneh, Ammar Salehisahlabadi, Andrew S. Day, Yong Zhang
Pharmacological Research.2020; 151: 104585. CrossRef
Magnitude of and prediction for risk of hepatocellular carcinoma in patients with chronic hepatitis B taking entecavir or tenofovir therapy: A systematic review
Cheng‐Hao Tseng, Chao‐Ming Tseng, Jia‐Ling Wu, Yao‐Chun Hsu, Hashem B. El-Serag
Journal of Gastroenterology and Hepatology.2020; 35(10): 1684. CrossRef
Efficacy of microwave ablation and entecavir as a combination treatment for primary liver cancer and their effects on hepatitis B virus and liver function
Hong Xu, Qiang Zhang, Yu-Lin Tan, Yang Zhang, Jian-Zhu Wei, Ling-Ling Wang, Bo Xie
All Life.2020; 13(1): 524. CrossRef
Hepatocellular carcinoma incidence with tenofovir versus entecavir in chronic hepatitis B: a systematic review and meta-analysis
Cheng-Hao Tseng, Yao-Chun Hsu, Tzu-Haw Chen, Fanpu Ji, I-Sung Chen, Ying-Nan Tsai, Hoang Hai, Le Thi Thanh Thuy, Tetsuya Hosaka, Hitomi Sezaki, John A Borghi, Ramsey Cheung, Masaru Enomoto, Mindie H Nguyen
The Lancet Gastroenterology & Hepatology.2020; 5(12): 1039. CrossRef
Waist Circumference and Risk of Liver Cancer: A Systematic Review and Meta-Analysis of over 2 Million Cohort Study Participants
Jamal Rahmani, Hamed Kord Varkaneh, Vasileios Kontogiannis, Paul M. Ryan, Hiba Bawadi, Somaye Fatahi, Yong Zhang
Liver Cancer.2020; 9(1): 6. CrossRef
Association of metabolic syndrome with the risk of developing liver disease in chronic hepatitis B patients
Julius Dongsogo, Christopher Larbie
African Journal of Biochemistry Research.2019; 13(2): 23. CrossRef
Effect of Korean Red Ginseng in chronic liver disease
Tae Young Park, Meegun Hong, Hotaik Sung, Sangyeol Kim, Ki Tae Suk
Journal of Ginseng Research.2017; 41(4): 450. CrossRef
New trends on obesity and NAFLD in Asia
Jian-Gao Fan, Seung-Up Kim, Vincent Wai-Sun Wong
Journal of Hepatology.2017; 67(4): 862. CrossRef

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Case Reports

Liver fibrosis, cirrhosis, and portal hypertension

A case of portal hypertension by presumed as plexiform neurofibroma at the hepatic hilum: Kyung Han Lee, Sun Hong Yoo, Gi Tark Noh, Won Suk Heo, Byung Seong Ko, Jung Ah Chio, Hyo Jin Cho, Jin Young Choi, Hee Jun Kim, Won Sohn, Sang Jong Park, Young Min Park; Clin Mol Hepatol 2016;22(2):276-280.
Published online May 20, 2016; DOI: https://doi.org/10.3350/cmh.2015.0021

Abstract
PDF

Neurofibromas can occur anywhere in the body, but they usually involve the head, neck, pelvis, and extremities. Abdominal visceral involvement is rare, and intrahepatic involvement is even less common. We describe a patient who suffered from plexiform neurofibromatosis with liver involvement. A 49-year-old man, who had previously been diagnosed with neurofibromatosis, underwent esophagogastroduodenoscopy and abdominal ultrasonography for screening purposes. Esophagogastroduodenoscopy showed grade 2 esophageal varices and abdominal ultrasonography showed conglomerated nodules with echogenic appearances in the perihepatic space. Magnetic resonance imaging showed presumed plexiform neurofibroma involving the lesser sac and hepatic hilum and encasing the common hepatic artery celiac trunk and superior mesenteric artery left portal triad. We report an unusual case of portal hypertension attributed to the compressive narrowing of the portal vein by presumed as plexiform neurofibroma at the lesser sac and hepatic hilum.

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Plexiform neurofibroma infiltrating uterine cervix and parametrium, causing hydronephrosis: A case report and review of the literature
Yasin Durmuş, Mustafa Koray Kırdağ, Kıvanç Yılmaz, Emre Aydın, Mesut Ozturk, Özlem Sezer
International Journal of Gynecology & Obstetrics.2025; 171(1): 202. CrossRef
Neurofibromatosis Type 1 with a Giant Diffuse Plexiform Neurofibroma Invading the Liver
Yuko Yokogawa, Tomohiro Suzuki, Hiroyuki Suzuki, Rena Nemoto, Hiroshi Shimizu, Tsuyoshi Ueda, Daiki Uchihara, Yoshinori Okubo, Osamu Ichii, Mayumi Tai, Yutaka Ejiri, Masaru Harada
Internal Medicine.2023; 62(20): 2971. CrossRef
Portal cavernoma in type 1 neurofibromatosis: A fortuitous or causal association?
Joanna Ashworth, Vasco Sousa Abreu, Isabel Couto Guerra, Susana Almeida, Catarina Cunha, Helena Moreira Silva, Ermelinda Santos Silva
American Journal of Medical Genetics Part A.2023; 191(7): 1963. CrossRef
Neurofibromatosis with Intrahepatic, Retroperitoneal and Pelvic Involvement: A Case Report and Literature Review
Huang, MS Danqing, Tang, MS Min, Li, MD Aimei, Yu, MD Decai, Chen, MD Jun, Wu, MS Min, Wang, MD Wenping, Kong, MD Wentao
ADVANCED ULTRASOUND IN DIAGNOSIS AND THERAPY.2022; 6(1): 29. CrossRef
A rare case of plexiform neurofibroma of the liver in a patient without neurofibromatosis type 1
Hiroko Nebiki, Shinsuke Hiramatsu, Yuhei Sakata, Takehisa Suekane, Tomoaki Yamasaki, Takashi Nakai, Yoichi Koda, Akishige Kanazawa, Takeshi Inoue
Clinical Journal of Gastroenterology.2020; 13(6): 1297. CrossRef
The concept of type 2 segmental mosaicism, expanding from dermatology to general medicine
R. Happle
Journal of the European Academy of Dermatology and Venereology.2018; 32(7): 1075. CrossRef
Nonoperative Management May Be a Viable Approach to Plexiform Neurofibroma of the Porta Hepatis in Patients with Neurofibromatosis-1
Natesh Yepuri, Rana Naous, Camille Richards, Dilip Kittur, Ajay Jain, Mashaal Dhir
HPB Surgery.2018; 2018: 1. CrossRef
Spectrum of gastrointestinal lesions of neurofibromatosis type 1: a pictorial review
Nada Garrouche, Amel Ben Abdallah, Nadia Arifa, Ibtissem Hasni, Yasser Ben Cheikh, Waad Ben Farhat, Sana Ben Amor, Hela Jemni
Insights into Imaging.2018; 9(5): 661. CrossRef
Rare triad of periampullary carcinoid, duodenal gastrointestinal stromal tumor and plexiform neurofibroma at hepatic hilum in neurofibromatosis type 1: a case report
Nihed Abdessayed, Rahul Gupta, Sarra Mestiri, Ahlem Bdioui, Mounir Trimech, Moncef Mokni
BMC Cancer.2017;[Epub] CrossRef

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Benign liver tumors and cystic disease of liver

Intrahepatic bile duct adenoma in a patient with chronic hepatitis B accompanied by elevation of alpha-fetoprotein: Jem Ma Ahn, Yong-Han Paik, Jun Hee Lee, Ju Yeon Cho, Won Sohn, Geum-Youn Gwak, Moon Seok Choi, Joon Hyeok Lee, Kwang Cheol Koh, Seung Woon Paik, Byung Chul Yoo; Clin Mol Hepatol 2015;21(4):393-397.
Published online December 24, 2015; DOI: https://doi.org/10.3350/cmh.2015.21.4.393

Abstract
PDF

A 51-year-old male patient with chronic hepatitis B was referred to our hospital due to a 1-cm liver nodule on ultrasonography. Alpha-fetoprotein (AFP) was slightly elevated. The nodule showed prolonged enhancement on dynamic liver magnetic resonance imaging and appeared as a hyperintensity on both diffusion-weighted and T2-weighted imaging. The nodule was followed up because it was small and typical findings of hepatocellular carcinoma (HCC) were not observed in the dynamic imaging investigations. However, liver contrast-enhanced ultrasonography performed 1 month later showed enhancement during the arterial phase and definite washout during the delayed phase. Also, AFP had increased to over 200 ng/mL even though AST and ALT were decreased after administering an antiviral agent. He was presumptively diagnosed as HCC and underwent liver segmentectomy. Microscopy findings of the specimen indicated bile duct adenoma. After resection, the follow-up AFP had decreased to within the normal range. This patient represents a case of bile duct adenoma with AFP elevation mimicking HCC on contrast-enhanced ultrasonography.

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Bile duct adenoma: imaging features and radiologic–pathologic correlation
Ryoji Tatsumi, Shin Ichihara, Hirokazu Suii, Masakatsu Yamaguchi, Tomohiro Arakawa, Tomoaki Nakajima, Yasuaki Kuwata, Itaru Ozeki, Shuhei Hige, Joji Toyota, Yoshiyasu Karino
Japanese Journal of Radiology.2020; 38(6): 561. CrossRef

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Original Article

Viral hepatitis

Static and dynamic prognostic factors for hepatitis-B-related acute-on-chronic liver failure: Jung Min Ha, Won Sohn, Ju Yeon Cho, Jeung Hui Pyo, Kyu Choi, Dong Hyun Sinn, Geum-Youn Gwak, Moon Seok Choi, Joon Hyeok Lee, Kwang Chul Koh, Seung Woon Paik, Byung Chul Yoo, Yong-Han Paik; Clin Mol Hepatol 2015;21(3):232-241.
Published online September 30, 2015; DOI: https://doi.org/10.3350/cmh.2015.21.3.232

Abstract
PDF

Background/Aims

Hepatitis-B-related acute-on-chronic liver failure has a poor prognosis. However, the advent of potent oral antiviral agents means that some patients can now recover with medical treatment. We aimed to identify the prognostic factors for hepatitis-B-related acute-on-chronic liver failure including the initial as well as the dynamically changing clinical parameters during admission.

Methods

Sixty-seven patients were retrospectively enrolled from 2003 to 2012 at Samsung Medical Center. The patients were classified into three categories: Recovery group (n=23), Liver transplantation group (n=28), and Death group (n=16). The Liver transplantation and Death groups were combined into an Unfavorable prognosis group. We analyzed the prognostic factors including the Model for End-Stage Liver Disease (MELD) scores determined at 3-day intervals.

Results

A multivariable analysis showed that the unfavorable prognostic factors were a high initial MELD score (≥28) (odds ratio [OR] =6.64, p=0.015), moderate-to-severe ascites at admission (OR=6.71, P=0.012), and the aggravation of hepatic encephalopathy during hospitalization (≥grade III) (OR=15.41, P=0.013). Compared with the baseline level, significant reductions in the MELD scores were observed on the 7th day after admission in the Recovery group (P=0.016).

Conclusions

Dynamic changes in clinical parameters during admission are useful prognostic factors for hepatitis-B-related acute-on-chronic liver failure.

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Li Bai, Wang Lu, Qi Yang, Xiaoxuan Liu, Yu Chen, Zhongping Duan
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Xue Li, Hao Li, Yucui Zhu, Huaqian Xu, Shanhong Tang
Journal of Clinical Medicine.2023; 12(3): 851. CrossRef
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Jhon Edwar García-Rueda, Ricardo Londoño-García, Tomás Marín-Cuartas, Juan Esteban Hernández-Abaunza, Sebastián Osorio-Rico, Angélica María Bermúdez-Flórez, Juan Carlos Restrepo-Gutiérrez
Hepatología.2022; : 72. CrossRef
KASL clinical practice guidelines for management of chronic hepatitis B

Clinical and Molecular Hepatology.2022; 28(2): 276. CrossRef
A dynamic prediction model for prognosis of acute-on-chronic liver failure based on the trend of clinical indicators
Zhenjun Yu, Yu Zhang, Yingying Cao, Manman Xu, Shaoli You, Yu Chen, Bing Zhu, Ming Kong, Fangjiao Song, Shaojie Xin, Zhongping Duan, Tao Han
Scientific Reports.2021;[Epub] CrossRef
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Man-Man Xu, Ming Kong, Peng-Fei Yu, Ying-Ying Cao, Fang Liu, Bing Zhu, Yi-Zhi Zhang, Wang Lu, Huai-Bin Zou, Bin-Wei Duan, Shao-Li You, Shao-Jie Xin, Tao Han, Zhong-Ping Duan, Yu Chen
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Wei Lin, Jing Zhang, Xiaohui Liu, Hongqun Liu, Jinqiu He, Ming Li, Shuqin Zhang, Hong Chen, Changqing Zhang, Wenfang Wu, Chenggang Jin, Samuel S. Lee, Zhongping Duan, Yuexin Zhang
Annals of Hepatology.2018; 17(3): 392. CrossRef

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