Increased lipotoxicity and insulin resistance in non diabetic patients with hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is the main type of primary liver cancer and although viral infections (HCV and HBV) and excess alcohol intake have been considered the major risk factors for HCC development, recent data showed that subjects with metabolic alterations, i.e., insulin resistance (IR) and type 2 diabetes (T2DM), are at higher risk for HCC. Hepatocarcinogenesis is a multistep process, which starts mostly by a chronic disease although it can develop independently of cirrhosis. The mechanisms for the development of HCC are still unknown but it has been hypothesized that derangement in lipid metabolism might lead to HCC through lipotoxicity, inflammation and apoptosis. Thus, we have studied if adipose tissue IR and hepatic lipid metabolism were altered in liver and plasma of patients with HCC undergoing liver transplant (LT