Blood magnesium level and risk of hepatocellular carcinoma in a prospective liver cirrhosis cohort
Menée à partir de données portant sur 1 460 patients présentant une cirrhose hépatique (durée médiane de suivi : 4,3 ans), cette étude évalue l'association entre le niveau sanguin de magnésium et le risque de développer un carcinome hépatocellulaire
Background: Higher magnesium intake was linked to lower risk of hepatocellular carcinoma (HCC). However, the relationship between blood magnesium level and HCC has not been fully characterized, especially among liver cirrhosis patients who are at higher risk for HCC.
Methods: In the Mass General Brigham Biobank, we developed a new prospective cohort of 1,460 liver cirrhosis patients without liver cancer history using the validated International Classification of Diseases codes. We used Cox proportional hazard models to generate hazard ratios (HRs) with 95% confidence intervals (CIs) for incident HCC, and used generalized estimating equations to compare changes in liver biomarkers according to baseline blood magnesium, adjusting for age, sex, race, lifestyles, body mass index, type 2 diabetes, model for end-stage liver disease score, and hepatitis infection.
Results: During a median follow-up period of 4.26 years, 109 developed HCC. Magnesium deficiency (<1.70mg/dL; N = 158) was associated with a higher risk of HCC (HR =1.88; 95%CI:1.10–3.22) compared to magnesium sufficiency. This association remained robust in the 1-year lag analysis (HR=2.19; 95%CI:1.12–4.29) and in sensitivity analysis excluding patients with alcoholic liver disease (HR=2.26; 95%CI:1.16–4.42). Magnesium in the lowest quartile was associated with a faster increase in alanine transaminase (β=3.74; 95%CI:0.51–6.97), direct bilirubin (β=0.18; 95%CI:0.01–0.35), and total bilirubin (β=0.20; 95%CI:0.02–0.37), compared to the highest quartile. Conclusions: Lower blood magnesium level is associated with higher HCC risk and unfavorable liver biomarkers changes.
Impact: If confirmed, our findings may potentially enable better identification of high-risk patients for HCC and inform better management strategies for liver cirrhosis.
Cancer Epidemiology, Biomarkers & Prevention , résumé, 2023