Diabetes mellitus and risk of hepatocellular carcinoma: a systematic review and meta-analysis
Diabetes/Metabolism Research and Reviews, 09/06/2011
Evidence Based Medicine
Wang P et al. – This meta–analysis shows that diabetes is associated with moderately increased risk of hepatocellular carcinoma (HCC) incidence, as well as HCC mortality. Considering the rapidly increasing prevalence of diabetes mellitus, the study underlines the need for cancer prevention in diabetic individuals.
Methods- Studies were identified by searching PUBMED and MEDLINE database up to February 2011.
- Pooled risk estimates were calculated using the random–effects model.
- Potential sources of heterogeneity were explored by subgroup analyses.
- A total of 17 case–control studies and 32 cohort studies were included in the meta–analysis.
- The combined risk estimate of all studies showed a statistically significant increased risk of HCC incidence among diabetic individuals (RR=2.31, 95% CI: 1.87, 2.84).
- The pooled risk estimate of 17 case–control studies (OR=2.40, 95% CI: 1.85, 3.11) was slightly higher than that from 25 cohort studies (RR=2.23, 95% CI: 1.68, 2.96).
- Metformin treatment was found with potentially protective effects against risk of HCC. On the contrary, long duration of diabetes and sulfonylureas or insulin treatment could increase HCC risk.
- Also meta–analysis of 7 cohort studies found a statistically significant increased risk of HCC mortality (RR=2.43, 95% CI: 1.66, 3.55) for individuals with (versus without) diabetes.
