hy de - indu ced ▁DNA ▁ad duct s ▁due ▁to ▁alco hol ▁consumption ▁does ▁not ▁appear ▁sufficient ▁to ▁cause ▁increased ▁mut agen esis . ▁ ▁However , ▁as ▁review ed ▁by ▁N ish ida ▁et ▁al ., ▁alco hol ▁expos ure , ▁causing ▁ox id ative ▁DNA ▁damage ▁( which ▁is ▁rep ai rable ), ▁can ▁result ▁in ▁ep igen etic ▁alter ations ▁at ▁the ▁sites ▁of ▁DNA ▁repair . ▁ ▁Al co hol - indu ced ▁ep igen etic ▁alter ations ▁of ▁gene ▁expression ▁appear ▁to ▁lead ▁to ▁li ver ▁injury ▁and ▁ultimately ▁car cin oma . ▁ ▁Ob es ity ▁is ▁associated ▁with ▁higher ▁risk ▁of ▁primary ▁li ver ▁cancer . ▁ ▁As ▁shown ▁with ▁m ice , ▁ob ese ▁m ice ▁are ▁pr one ▁to ▁li ver ▁cancer , ▁likely ▁due ▁to ▁two ▁factors . ▁ ▁Ob ese ▁m ice ▁have ▁increased ▁pro - infl am mat ory ▁cy tok ines . ▁Ob ese ▁m ice ▁also ▁have ▁higher ▁levels ▁of ▁de ox ych ol ic ▁acid ▁( D CA ), ▁a ▁product ▁of ▁b ile ▁acid ▁alter ation ▁by ▁certain ▁gut ▁micro bes , ▁and ▁these ▁micro bes ▁are ▁increased ▁with ▁ob es ity . ▁ ▁The ▁excess ▁D CA ▁causes ▁DNA ▁damage ▁and ▁infl amm ation ▁in ▁the ▁li ver , ▁which , ▁in ▁turn , ▁can ▁lead ▁to ▁li ver ▁cancer . ▁ ▁Other ▁relevant ▁aspects ▁A ▁common ▁form ▁of ▁li ver ▁disease ▁is ▁vir al ▁in fection . ▁Vir al ▁he pat it ides ▁such