Evidence mapPaperPMID 41071622Full record

ReviewEuropean journal of clinical investigation2026

Metabolic dysfunction-associated steatotic liver disease, insulin resistance and hepatocellular carcinoma: A deadly triad.

Alfredo Caturano, Enes Erul, Roberto Nilo, Davide Nilo, Vincenzo Russo, Luca Rinaldi, Carlo Acierno, Erman Akkus, Katerina Koudelkova, Federica Cerini and 6 more

Abstract readReview
In one paragraph

Review in European journal of clinical investigation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Article
  5. Article
  6. Journal of gastrointestinal oncology · 2026
    Article
  7. Review
  8. Review
  9. Review
  10. Article
  11. Article
  12. Review
  13. Review
  14. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Alfredo CaturanoDepartment of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma University, Rome, Italy.
Enes ErulDepartment of Medical Oncology, Ankara University Faculty of Medicine, Ankara, Turkey.
Roberto NiloData Collection G-STeP Research Core Facility, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Davide NiloDepartment of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy.ORCID https://orcid.org/0009-0000-9617-4491
Vincenzo RussoDepartment of Biology, College of Science and Technology, Sbarro Institute for Cancer Research and Molecular Medicine, Temple University, Philadelphia, Pennsylvania, USA.ORCID https://orcid.org/0000-0002-9227-0360
Luca RinaldiDepartment of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy.
Carlo AciernoAzienda Ospedaliera Regionale San Carlo, Potenza, Italy.
Erman AkkusDepartment of Medical Oncology, Ankara University Faculty of Medicine, Ankara, Turkey.
Katerina KoudelkovaThird Faculty of Medicine, Charles University, Prague, Czech Republic.
Federica CeriniIRCCS MultiMedica, Milan, Italy.
Alessandro RizzoS.S.D. C.O.R.O. Bed Management Presa in Carico, TDM, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy.
Ferdinando Carlo SassoDepartment of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy.
Leonilde BonfrateDepartment of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma University, Rome, Italy.ORCID https://orcid.org/0000-0002-4955-7964
Antonio GiordanoDepartment of Biology, College of Science and Technology, Sbarro Institute for Cancer Research and Molecular Medicine, Temple University, Philadelphia, Pennsylvania, USA.
Hatime Arzu YaşarDepartment of Medical Oncology, Ankara University Faculty of Medicine, Ankara, Turkey.
Caterina ConteDepartment of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma University, Rome, Italy.ORCID https://orcid.org/0000-0001-7066-5292

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMetabolic dysfunction-associated steatotic liver disease (MASLD) has become a leading cause of chronic liver disease worldwide, driven by the increasing prevalence of obesity and insulin resistance (IR). IR, a central feature of the metabolic syndrome, promotes hepatic lipid accumulation, inflammation and mitochondrial dysfunction, fostering the transition from steatosis to advanced liver injury and hepatocellular carcinoma (HCC). This review summarizes current evidence on the molecular mechanisms linking MASLD, IR and HCC, highlighting the role of insulin resistance in liver carcinogenesis and disease progression.

methodsA comprehensive literature search was conducted to identify experimental, clinical and epidemiological studies addressing the interplay between MASLD, IR and HCC. Key molecular pathways and risk profiles were synthesised and compared across etiologies.

resultsIR contributes to hepatic lipid deposition, oxidative stress and chronic inflammation through activation of PI3K/Akt and mTOR signalling. The coexistence of MASLD and IR enhances pro-inflammatory and pro-fibrotic pathways, accelerating the evolution to HCC. Patients with MASLD-associated HCC exhibit distinct metabolic and molecular characteristics compared with those with viral or alcohol-related HCC. Novel biomarkers and advanced imaging modalities show promise for identifying high-risk individuals at earlier disease stages.

conclusionsAlthough substantial progress has been made in understanding the MASLD-IR-HCC axis, critical gaps remain regarding genetic, environmental and metabolic determinants. A multidisciplinary approach integrating metabolic, molecular and oncologic research is essential for improving early detection, risk stratification and the development of targeted therapies against metabolic liver cancer.

Indexed as

Carcinoma, HepatocellularFatty LiverInsulin ResistanceLiver NeoplasmsMetabolic SyndromeHumansInflammationNon-alcoholic Fatty Liver DiseaseObesityOxidative StressSignal TransductionTOR Serine-Threonine KinasesTOR Serine-Threonine Kinasescancer progressionhepatocellular carcinomainsulin resistancemetabolic dysregulationmolecular pathwaystumorigenesis

Identifiers

PMID41071622
PMCPMC12817244

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.