Antidiabetic therapy and increased risk of hepatocellular carcinoma in chronic liver disease

[Guest guest]

World J Gastroenterol. 2009 May 28;15(20):2506-11.

Antidiabetic therapy and increased risk of hepatocellular carcinoma in chronic

liver disease.

Donadon V, Balbi M, Ghersetti M, Grazioli S, Perciaccante A, Della Valentina G,

Gardenal R, Dal Mas M, Casarin P, Zanette G, Miranda C.

Department of Medicine, Internal Medicine 3rd, Pordenone Hospital, Pordenone,

Italy. valter.donadon@...

AIM: To explore the association between hepatocellular carcinoma (HCC) and type

2 diabetes mellitus, describe the temporal relations between the onset of

diabetes and the development of HCC and evaluate the possible effects of

antidiabetic therapy on HCC risk. METHODS: We recruited 465 HCC patients, 618

with cirrhosis and 490 control subjects. We evaluated the odds ratio (OR) for

HCC by univariate and multivariate analysis. Moreover, OR for HCC in diabetic

subjects treated with insulin or sulphanylureas and with metformin were

calculated. RESULTS: The prevalence of diabetes mellitus was 31.2% in HCC, 23.3%

in cirrhotic patients and 12.7% in the Control group. By univariate and

multivariate analysis, the OR for HCC in diabetic patients were respectively

3.12 (CI 2.2-4.4, P < 0.001) and 2.2 (CI 1.2-4.4, P = 0.01). In 84.9% of cases,

type 2 diabetes mellitus was present before the diagnosis of HCC. Moreover, we

report an OR for HCC of 2.99 (CI 1.34-6.65, P = 0.007) in diabetic patients

treated with insulin or sulphanylureas, and an OR of 0.33 (CI 0.1-0.7, P =

0.006) in diabetic patients treated with metformin. CONCLUSION: Our study

confirms that type 2 diabetes mellitus is an independent risk factor for HCC and

pre-exists in the majority of HCC patients. Moreover, in male patients with type

2 diabetes mellitus, our data shows a direct association of HCC with insulin and

sulphanylureas treatment and an inverse relationship with metformin therapy.

PMID: 19469001 [PubMed - in process]

PMCID: PMC2686909

[Guest guest]

World J Gastroenterol. 2009 May 28;15(20):2506-11.

Antidiabetic therapy and increased risk of hepatocellular carcinoma in chronic

liver disease.

Donadon V, Balbi M, Ghersetti M, Grazioli S, Perciaccante A, Della Valentina G,

Gardenal R, Dal Mas M, Casarin P, Zanette G, Miranda C.

Department of Medicine, Internal Medicine 3rd, Pordenone Hospital, Pordenone,

Italy. valter.donadon@...

AIM: To explore the association between hepatocellular carcinoma (HCC) and type

2 diabetes mellitus, describe the temporal relations between the onset of

diabetes and the development of HCC and evaluate the possible effects of

antidiabetic therapy on HCC risk. METHODS: We recruited 465 HCC patients, 618

with cirrhosis and 490 control subjects. We evaluated the odds ratio (OR) for

HCC by univariate and multivariate analysis. Moreover, OR for HCC in diabetic

subjects treated with insulin or sulphanylureas and with metformin were

calculated. RESULTS: The prevalence of diabetes mellitus was 31.2% in HCC, 23.3%

in cirrhotic patients and 12.7% in the Control group. By univariate and

multivariate analysis, the OR for HCC in diabetic patients were respectively

3.12 (CI 2.2-4.4, P < 0.001) and 2.2 (CI 1.2-4.4, P = 0.01). In 84.9% of cases,

type 2 diabetes mellitus was present before the diagnosis of HCC. Moreover, we

report an OR for HCC of 2.99 (CI 1.34-6.65, P = 0.007) in diabetic patients

treated with insulin or sulphanylureas, and an OR of 0.33 (CI 0.1-0.7, P =

0.006) in diabetic patients treated with metformin. CONCLUSION: Our study

confirms that type 2 diabetes mellitus is an independent risk factor for HCC and

pre-exists in the majority of HCC patients. Moreover, in male patients with type

2 diabetes mellitus, our data shows a direct association of HCC with insulin and

sulphanylureas treatment and an inverse relationship with metformin therapy.

PMID: 19469001 [PubMed - in process]

PMCID: PMC2686909