[Click! Health] High Blood Sugar Patients Have Greater Risk of Liver Cancer When Drinking Alcohol

A study has found that higher fasting blood glucose levels significantly increase the risk of liver cancer when drinking alcohol. The medical community advises stricter abstinence from alcohol not only for diabetes but also for the prediabetes stage to prevent liver cancer.

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Seoul National University Hospital announced that a joint research team led by Professors Yoo Soo-jong and Cho Eun-joo, Professor Jung Go-eun from the Gangnam Center, and Professor Han Kyung-do from Soongsil University analyzed the association between alcohol consumption and liver cancer risk according to blood glucose levels in 9,387,670 adults who participated in the 2009 National Health Screening.

According to national cancer registry statistics, liver cancer is the seventh most common cancer in South Korea, with a poor prognosis as six out of ten patients die within five years. Major risk factors include liver cirrhosis, hepatitis B/C viruses, overweight, smoking, excessive drinking, and diabetes.

With recent advances in vaccination and the development of effective antiviral drugs, liver cancer caused by hepatitis viruses is expected to decrease gradually. Therefore, the research team explained that the importance of excessive drinking and diabetes as risk factors for liver cancer is increasing. Previous studies have shown that 'excessive alcohol consumption' and 'high blood glucose levels' induce oxidative stress, increasing the risk of liver cancer. However, the combined effect of these two risk factors on liver cancer occurrence has not been studied until now.

The research team classified 9.38 million adults into three groups based on fasting blood glucose levels measured during health screenings: ▲normal blood glucose (<100 mg/dL), ▲prediabetes (100?125 mg/dL), and ▲diabetes (≥126 mg/dL). Each group was further divided by weekly alcohol consumption into ▲non-drinkers (0 g), ▲light to moderate drinkers (1?209 g), and ▲heavy drinkers (≥210 g). The weekly alcohol intake was calculated by multiplying the self-reported frequency (days) and amount (glasses) of drinking, with one glass defined as containing 8 g of alcohol.

Over a median follow-up period of 8.3 years, liver cancer developed in 0.37% (34,321) of the participants. Analysis of liver cancer risk ratios by group showed that liver cancer risk increased with alcohol consumption across all blood glucose statuses. Notably, compared to the normal and prediabetes groups, the diabetes group showed the greatest increase in liver cancer risk with increased alcohol intake.

Compared to the normal blood glucose non-drinking group, the liver cancer risk was 1.19 times higher in the prediabetes light to moderate drinking group and 1.67 times higher in the prediabetes heavy drinking group. In the diabetes group, the risk increased by 2.02 times and 3.29 times for light to moderate and heavy drinking, respectively. This indicates that higher blood glucose levels amplify the increase in liver cancer risk associated with alcohol consumption.

Additionally, compared to the normal blood glucose non-drinking group, the liver cancer risk was 1.39 times higher in the normal blood glucose heavy drinking group. Conversely, the diabetes non-drinking group showed a 1.64 times higher risk, exceeding that of the normal blood glucose heavy drinking group. This suggests that diabetic patients have a high risk of liver cancer regardless of alcohol consumption.

The research team advises that individuals diagnosed with diabetes or prediabetes should actively abstain from alcohol to prevent liver cancer. Professor Yoo Soo-jong of Seoul National University Hospital's Department of Gastroenterology stated, "This study is the first to investigate the interaction between alcohol consumption and blood glucose status affecting liver cancer risk," adding, "Since the same amount of alcohol can significantly increase liver cancer risk depending on an individual's blood glucose status, a personalized approach is necessary when establishing liver cancer prevention strategies."

The study results were published online in the international medical journal PLOS Medicine.

(From left) Professors Yusoo Jong and Eunju Jo from Seoul National University Hospital, Professor Go-eun Jeong from Gangnam Center, and Professor Kyungdo Han from Soongsil University. [Photo by Seoul National University Hospital]