fig1

Figure 1. Triangle of hepatocarcinogenesis in metabolic syndrome: hepatocellular carcinoma (HCC) risk in nonalcoholic steatohepatitis (NASH) significantly increases with progression of liver fibrosis. Independently, type II diabetes mellitus promotes progression from nonalcoholic fatty liver (NAFL) to NASH, but needs to be recognized as an individual predisposing HCC-risk factor since peripheral insulin resistance may promote hepatocarcinogenesis even in the absence of cirrhosis^[4^]. Microbiome alterations, sedentary lifestyle, genetic polymorphisms, and obesity represent additional factors aggravating HCC risk in the NASH population