High producer variant of lipoprotein lipase may protect from hepatocellular carcinoma in alcohol-associated cirrhosis

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • F. Schmalz - (Author)
  • Janett Fischer - , University Hospital Leipzig (Author)
  • H. Innes - (Author)
  • S. Buch - , Department of Internal Medicine I (Author)
  • C. Möller - (Author)
  • M. Matz-Soja - (Author)
  • W. von Schönfels - (Author)
  • B. Krämer - (Author)
  • B. Langhans - (Author)
  • A. Klüners - (Author)
  • M. Soyka - (Author)
  • F. Stickel - (Author)
  • J. Nattermann - (Author)
  • C.P. Strassburg - (Author)
  • T. Berg - , University Hospital Leipzig (Author)
  • P. Lutz - (Author)
  • H.D. Nischalke - (Author)

Abstract

Background & Aims: Progression of alcohol-associated liver disease (ALD) is driven by genetic predisposition. The rs13702 variant in the lipoprotein lipase (LPL) gene is linked to non-alcoholic fatty liver disease. We aimed at clarifying its role in ALD. Methods: Patients with alcohol-associated cirrhosis, with (n = 385) and without hepatocellular carcinoma (HCC) (n = 656), with HCC attributable to viral hepatitis C (n = 280), controls with alcohol abuse without liver damage (n = 366), and healthy controls (n = 277) were genotyped regarding the LPL rs13702 polymorphism. Furthermore, the UK Biobank cohort was analysed. LPL expression was investigated in human liver specimens and in liver cell lines. Results: Frequency of the LPL rs13702 CC genotype was lower in ALD with HCC in comparison to ALD without HCC both in the initial (3.9% vs. 9.3%) and the validation cohort (4.7% vs. 9.5%; p <0.05 each) and compared with patients with viral HCC (11.4%), alcohol misuse without cirrhosis (8.7%), or healthy controls (9.0%). This protective effect (odds ratio [OR] = 0.5) was confirmed in multivariate analysis including age (OR = 1.1/year), male sex (OR = 3.0), diabetes (OR = 1.8), and carriage of the PNPLA3 I148M risk variant (OR = 2.0). In the UK Biobank cohort, the LPL rs13702 C allele was replicated as a risk factor for HCC. Liver expression of LPL mRNA was dependent on LPL rs13702 genotype and significantly higher in patients with ALD cirrhosis compared with controls and alcohol-associated HCC. Although hepatocyte cell lines showed negligible LPL protein expression, hepatic stellate cells and liver sinusoidal endothelial cells expressed LPL. Conclusions: LPL is upregulated in the liver of patients with alcohol-associated cirrhosis. The LPL rs13702 high producer variant confers protection against HCC in ALD, which might help to stratify people for HCC risk. Impact and implications: Hepatocellular carcinoma is a severe complication of liver cirrhosis influenced by genetic predisposition. We found that a genetic variant in the gene encoding lipoprotein lipase reduces the risk for hepatocellular carcinoma in alcohol-associated cirrhosis. This genetic variation may directly affect the liver, because, unlike in healthy adult liver, lipoprotein lipase is produced from liver cells in alcohol-associated cirrhosis.

Details

Original languageEnglish
Article number100684
Number of pages12
Journal JHEP reports / EASL
Volume5(2023)
Issue number4
Publication statusPublished - Apr 2023
Peer-reviewedYes

External IDs

Scopus 85149068344
PubMed 36879887
WOS 000997565000001
Mendeley 6cfebdd8-e84d-31a6-bc67-b84e52337d06

Keywords

DFG Classification of Subject Areas according to Review Boards

Sustainable Development Goals

Keywords

  • Alcohol-associated liver disease, Cirrhosis, HCC, LPL, rs13702, rs328, Rs13702, Rs328, Relative LPL mRNA expression, Hcc, Lpl