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Beom Kyung Kim

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Open access Aug 2026

The impact of alcohol consumption on the risk of hepatocellular carcinoma across different age groups: A nationwide cohort study.

BACKGROUND AND AIMS Alcohol consumption is a well-established risk factor for HCC, though its impact may vary across different age groups. Accordingly, we aimed to investigate the association between alcohol consumption and the risk of HCC across different age groups. METHODS We included 4,234,445 participants aged ≥20 years who underwent a national health examination in 2009. Cox proportional hazards regression models were used to investigate the association of alcohol consumption with the risk of HCC across age groups. RESULTS Among 3,869,084 participants, 20,475 individuals were newly diagnosed with HCC during a median follow-up of 11.3 years. When stratified by 20-year age groups, increasing alcohol consumption was significantly associated with an increased risk of HCC in the ≥60 age group compared to no alcohol consumption (P for trend <0.001). Heavy alcohol consumption was significantly associated with an increased risk of HCC in the 40-59 and ≥60 age groups, with larger effect estimates observed at older ages (aHR, 1.11; 95% CI, 1.05-1.18 for the 40-59 age group; aHR, 1.47; 95% CI, 1.38-1.57 for the ≥60 age group). CONCLUSIONS Our findings indicate that the association between alcohol consumption and the risk of HCC differs across age groups, with the most pronounced risk increase observed among older individuals. These findings may inform age-tailored HCC risk assessment and prevention strategies, particularly by identifying middle-aged and older heavy drinkers who may benefit from more careful risk stratification. IMPACT AND IMPLICATIONS Alcohol consumption is a well-established risk factor for hepatocellular carcinoma (HCC), but its age-specific impact remains insufficiently defined. In this nationwide cohort of 3,869,084 adults, heavy alcohol consumption was associated with increased HCC risk in the 40-59 and ≥60 age groups, with the strongest association and highest 10-year cumulative risk observed among heavy drinkers aged ≥60 years. These findings may help refine age-tailored HCC risk assessment by supporting the consideration of heavy alcohol consumption alongside established liver-related risk factors, particularly in middle-aged and older adults.

Mi Na Kim, Kyungdo Han, Dong Yun Kim et al. · JHEP Reports · 0 citations

Open access Jul 2026

The risk of cardiovascular events in metabolic dysfunction–associated steatotic liver disease according to fibrosis stage and diabetes status: A cohort study

Background: Atherosclerotic cardiovascular disease (ASCVD) is a major cause of morbidity and mortality in metabolic dysfunction–associated steatotic liver disease (MASLD). We investigated whether fibrosis severity assessed using guideline-recommended noninvasive liver fibrosis pathways was associated with incident ASCVD across different glycemic states. Methods: This retrospective cohort study included subjects with MASLD. Fibrosis severity was classified using the Korean Association for the Study of the Liver/European Association for the Study of the Liver (KASL/EASL) and American Gastroenterological Association (AGA) sequential pathways, based on fibrosis-4 followed by vibration-controlled transient elastography. Incident ASCVD was analyzed using Fine-Gray subdistribution hazard models, with death treated as a competing event. Results: Among 6519 subjects with MASLD who had both fibrosis-4 and vibration-controlled transient elastography data, 3243 had normoglycemia, 2369 had prediabetes, and 907 had diabetes; 3221 were included in the survival analysis cohort. Baseline 10-year ASCVD risk increased with worsening glycemic status. In the longitudinal analysis, the association between fibrosis severity and incident ASCVD differed by glycemic status. In patients with prediabetes, the highest fibrosis tier was associated with higher incident ASCVD risk (adjusted subdistribution hazard ratio: 2.62, p=0.024). This association was also more apparent in younger individuals. In patients with diabetes, 5-year cumulative ASCVD incidence was high across fibrosis tiers (15.2%–18.5%), without a significant increase by fibrosis severity. Conclusions: Higher liver fibrosis severity assessed by noninvasive tests was associated with incident ASCVD outcomes in selected MASLD subgroups, particularly patients with prediabetes and younger individuals. Fibrosis assessment may help identify patients who warrant closer cardiometabolic evaluation when interpreted alongside established ASCVD risk prediction tools.

Jaehong Jeong, J. Hong, Dong Yun Kim et al. · Hepatology Communications · 0 citations