IGF1 and metabolic syndrome: MetS is likely to be a proxy for other cancer risk factors, such as low physical activity, intake of high caloric food producing a high quantity of heat, high dietary fat intake, low fiber intake, and oxidative stress [29].The mechanisms by which DM induces HCC are related to insulin-like growth factor I (IGF-I) or insulin-like growth factor-binding protein-3 (IGFBP-3) [6].