Background: Hispanics in South Texas have high rates of hepatocellular carcinoma (HCC) and nonalcoholic fatty liver disease (NAFLD). Liver fibrosis severity is the strongest predictive factor of NAFLD progression to HCC. We examined the association between free fatty acids (FA) and advanced liver fibrosis or HCC in this population. Methods: We quantified 45 FAs in plasma of 116 subjects of the Cameron County Hispanic Cohort, 15 Hispanics with HCC, and 56 first/second-degree relatives of Hispanics with HCC. Liver fibrosis was assessed by FibroScan. Results: Advanced liver fibrosis was significantly associated with low expression of very long chain (VLC) saturated FAs (SFA), odd chain SFAs, and VLC n-3 polyunsaturated FAs [PUFA; AOR; 95% confidence interval (CI), 10.4 (3.7–29.6); P < 0.001; 5.7 (2.2–15.2); P < 0.001; and 3.7 (1.5–9.3); P = 0.005]. VLC n3-PUFAs significantly improved the performance of the noninvasive markers for advanced fibrosis - APRI, FIB-4, and NFS. Plasma concentrations of VLC SFAs and VLC n-3 PUFAs were further reduced in patients with HCC. Low concentrations of these FAs were also observed in relatives of patients with HCC and in subjects with the PNPLA3 rs738409 homozygous genotype. Conclusions: Low plasma concentrations of VLC n-3 PUFAs and VLC SFAs were strongly associated with advanced liver fibrosis and HCC in this population. Genetic factors were associated with low concentrations of these FAs as well. Impact: These results have implications in identifying those at risk for liver fibrosis progression to HCC and in screening this population for advanced fibrosis. They also prompt the evaluation of VLC n-3 PUFA or VLC SFA supplementation to prevent cirrhosis and HCC.

中文翻译：

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循环脂肪酸与德克萨斯州南部西班牙裔晚期肝纤维化和肝细胞癌相关


背景：德克萨斯州南部的西班牙裔人肝细胞癌 (HCC) 和非酒精性脂肪肝 (NAFLD) 的发病率很高。肝纤维化严重程度是 NAFLD 进展为 HCC 的最强预测因素。我们研究了该人群中游离脂肪酸 (FA) 与晚期肝纤维化或 HCC 之间的关联。方法：我们对卡梅伦县西班牙裔队列的 116 名受试者、15 名患有 HCC 的西班牙裔以及 56 名患有 HCC 的西班牙裔的一级/二级亲属的血浆中的 45 种 FA 进行了定量。通过 FibroScan 评估肝纤维化。结果：晚期肝纤维化与极长链 (VLC) 饱和 FA (SFA)、奇数链 SFA 和 VLC n-3 多不饱和 FA [PUFA；PUFA；SFA] 的低表达显着相关。责任区； 95% 置信区间 (CI)，10.4 (3.7–29.6)； P<0.001； 5.7（2.2-15.2）； P<0.001； 3.7（1.5-9.3）； P = 0.005]。 VLC n3-PUFA 显着改善了晚期纤维化非侵入性标志物 - APRI、FIB-4 和 NFS 的性能。 HCC 患者中 VLC SFA 和 VLC n-3 PUFA 的血浆浓度进一步降低。在 HCC 患者的亲属和具有 PNPLA3 rs738409 纯合基因型的受试者中也观察到这些 FA 的浓度较低。结论：VLC n-3 PUFA 和 VLC SFA 血浆浓度低与该人群的晚期肝纤维化和 HCC 密切相关。遗传因素也与这些 FA 浓度低有关。影响：这些结果对于识别那些有肝纤维化进展为 HCC 风险的人群以及筛查该人群的晚期纤维化具有重要意义。他们还提示评估 VLC n-3 PUFA 或 VLC SFA 补充剂预防肝硬化和 HCC 的作用。