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Objective <p>To investigate cancer disparities between lean (BMI &lt; 25&#xa0;kg/m²; &lt; 23&#xa0;kg/m² for Asians) and non-lean metabolic dysfunction-associated steatohepatitis (MASH) by analyzing the prevalence of the 18 most common cancers in a large U.S. cohort.</p> Methods <p>This retrospective cohort study utilized the National Inpatient Sample (2016–2020) with weighted data to project findings to the general population. Patients were categorized as lean or non-lean based on BMI during hospitalization, excluding alternative etiologies via validated algorithms. Outcomes included composite cancer prevalence (primary) and individual cancer prevalence (secondary). Multivariable logistic regression was applied to assess differences.</p> Results <p>Among 34,955,252 U.S. hospitalizations, 539,275 patients had MASH (mean age: 64 years for lean vs. 58.8 years for non-lean; &gt;60% female). Lean MASH hospitalizations had higher odds of lung (aOR 1.76, CI 1.33–2.10, <i>P</i> &lt; 0.001), colon (aOR 1.23, CI 1.02–1.48, <i>P</i> = 0.027), kidney (aOR 1.27, CI 1.10–1.44, <i>P</i> = 0.001), liver (aOR 1.21, CI 1.12–1.31, <i>P</i> &lt; 0.001), and cervical cancers (aOR 3.25, CI 1.07–9.86, <i>P</i> = 0.037), as well as non-Hodgkin’s lymphoma (aOR 1.28, CI 1.08–1.51, <i>P</i> = 0.004), but lower odds of endometrial cancer (aOR 0.35, CI 0.25–0.50, <i>P</i> &lt; 0.001).</p> Conclusion <p>Lean MASH hospitalizations are linked to higher odds of several cancers despite lower BMI, underscoring the need for a nuanced understanding of cancer risks in MASH. BMI alone may not fully capture oncologic risk in this population.</p>

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Cancer disparities in lean vs. non-lean MASH: insight from a national inpatient sample

  • 期刊论文

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  • 发表日期：

    2025年9月26日

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  • Chukwunonso Ezeani,
  • Chidiebele Omaliko,
  • Petr Protiva,
  • Yazan A. Al-Ajlouni,
  • Gyanprakash Ketwaroo,
  • Basile Njei

摘要

Objective

To investigate cancer disparities between lean (BMI < 25 kg/m²; < 23 kg/m² for Asians) and non-lean metabolic dysfunction-associated steatohepatitis (MASH) by analyzing the prevalence of the 18 most common cancers in a large U.S. cohort.

Methods

This retrospective cohort study utilized the National Inpatient Sample (2016–2020) with weighted data to project findings to the general population. Patients were categorized as lean or non-lean based on BMI during hospitalization, excluding alternative etiologies via validated algorithms. Outcomes included composite cancer prevalence (primary) and individual cancer prevalence (secondary). Multivariable logistic regression was applied to assess differences.

Results

Among 34,955,252 U.S. hospitalizations, 539,275 patients had MASH (mean age: 64 years for lean vs. 58.8 years for non-lean; >60% female). Lean MASH hospitalizations had higher odds of lung (aOR 1.76, CI 1.33–2.10, P < 0.001), colon (aOR 1.23, CI 1.02–1.48, P = 0.027), kidney (aOR 1.27, CI 1.10–1.44, P = 0.001), liver (aOR 1.21, CI 1.12–1.31, P < 0.001), and cervical cancers (aOR 3.25, CI 1.07–9.86, P = 0.037), as well as non-Hodgkin’s lymphoma (aOR 1.28, CI 1.08–1.51, P = 0.004), but lower odds of endometrial cancer (aOR 0.35, CI 0.25–0.50, P < 0.001).

Conclusion

Lean MASH hospitalizations are linked to higher odds of several cancers despite lower BMI, underscoring the need for a nuanced understanding of cancer risks in MASH. BMI alone may not fully capture oncologic risk in this population.