Hepatokines and adipokines in NASH-related hepatocellular carcinoma

Abstract

Summary The incidence of hepatocellular carcinoma (HCC) is increasing in industrialised societies; this is likely secondary to the increasing burden of non-alcoholic fatty liver disease (NAFLD), its progressive form non- alcoholic steatohepatitis (NASH), and the metabolic syndrome. Cumulative studies suggest that NAFLD- related HCC may also develop in non-cirrhotic livers. However, prognosis and survival do not differ between NAFLD- or virus-associated HCC. Thus, research has increasingly focused on NAFLD-related risk factors to better understand the biology of hepatocarcinogenesis and to develop new diagnostic, pre- ventive, and therapeutic strategies. One important aspect thereof is the role of hepatokines and adipo- kines in NAFLD/NASH-related HCC. In this review, we compile current data supporting the use of hepatokines and adipokines as potential markers of disease progression in NAFLD or as early markers of NAFLD-related HCC. While much work must be done to elucidate the mechanisms and interactions underlying alterations to hepatokines and adipokines, current data support the possible utility of these factors – in particular, angiopoietin-like proteins, fi broblast growth factors, and apelin – for detection or even as therapeutic targets in NAFLD-related HCC.