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

查看全文 作  者:Valter [1]Donadon;Massimiliano [1]Balbi;Michela [1]Ghersetti;Silvia [1]Grazioli;Antonio [1]Perciaccante;Giovanni Della [1]Valentina;Rita [1]Gardenal;Maria Dal [1]Mas;Pietro [1]Casarin;Giorgio [2]Zanette;Cesare [2]Miranda 高影响力作者 机构地区:[1]Department of Medicine, Internal Medicine 3rd, Pordenone Hospital;[2]Diabetes Clinic, Pordenone Hospital, Via Montereale 24, Pordenone 33170, Italy高影响力机构 出  处:《World Journal of Gastroenterology》索引2009年第15卷第20期,共6页高影响力期刊 摘  要: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 confi rms 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. 关 键 词:肝癌 治疗 风险 降糖 2型糖尿病 肝病 慢性 二甲双胍
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