Association between hepatocellular carcinoma and type 2 diabetes mellitus in Italy： Potential role of insulin

• Published in: World journal of gastroenterology : WJG Vol. 14; no. 37; pp. 5695 - 5700
• Main Authors: Donadon, Valter, Balbi, Massimiliano, Casarin, Pietro, Vario, Alessandro, Alberti, Alfredo
• Format: Journal Article
• Language: English
• Published: United States The WJG Press and Baishideng 07.10.2008
• Subjects: 2型糖尿病; Aged; Carcinoma, Hepatocellular - epidemiology; Carcinoma, Hepatocellular - etiology; Case-Control Studies; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - epidemiology; Female; Humans; Hypoglycemic Agents - adverse effects; Hypoglycemic Agents - therapeutic use; Insulin - adverse effects; Insulin - therapeutic use; Italy - epidemiology; Liver Neoplasms - epidemiology; Liver Neoplasms - etiology; Male; Metformin - therapeutic use; Middle Aged; Odds Ratio; Prevalence; Rapid Communication; Risk Assessment; Risk Factors; Sex Factors; Sulfonylurea Compounds - therapeutic use; Time Factors; 抗糖尿病治疗; 肝炎病毒; 肝细胞癌; 胰岛素; Italy
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.14.5695

AIM： To investigate the relationships between Type 2 diabetes mellitus （DM2） and the risk of hepatocellular carcinoma （HCC）. METHODS： We studied the association between DM2 and HCC in a large case-control study that enrolled 465 consecutive Caucasian patients with HCC （78.3% males, mean age 68.5 ± 8.9 years） compared with an age and sex matched control group of 490 subjects. RESULTS： Prevalence of DM2 was significantly higher in HCC patients （31.2% vs 12.7%; OR = 3.12, 95% CI： 2.22-4.43） and in HCC cases with alcohol abuse. DM2 has been diagnosed before the appearance of HCC in 84.1% of diabetic HCC subjects with mean duration of 141.5 mo, higher in cases treated with insulin than in those with oral antidiabetic agents （171.5 vs 118.7 mo）. Compared to controls, males DM2 with HCC were more frequently treated with insulin （38.1% vs 17.6%, P = 0.009） and with sulfonylurea with or without metformin than with diet with or without metformin （84% vs 68.3%, P = 0.049）. CONCLUSION： DM2 in our patients is associated with a 3-fold increase risk of HCC. In most of our cases DM2 pre-existed to HCC. Patients with DM2 and chronic liver disease, particularly insulin treated males, should be considered for HCC close surveillance programs.