糖尿病与原发性肝癌:危险因素还是致病病因?

Diabetes mellitus and primary liver cancer: risk factor or real cause?

糖尿病发病率在全球范围内普遍升高,并被认为是非病毒性肝炎患者发生肝癌的潜在病因。糖尿病是否为肝癌的致病病因及发病机制目前仍不明确。回顾了近期大样本的队列研究,证实了糖尿病增加肝癌的发病率并影响其预后。同时阐述了丙型肝炎、肥胖及非酒精性脂肪性肝病与糖尿病及肝癌之间的密切关系,分析了胰岛素抵抗及慢性炎症因子的激活可能参与了癌细胞的产生及增殖。评述了抗胰岛素抵抗的药物对肝癌发生发展的影响。认为糖尿病可能是肝癌发生的致病病因,有效控制胰岛素抵抗有助于减少糖尿病相关肝癌的发生及进展。

With an increasing prevalence all over the world,diabetes mellitus is considered as a potential cause of liver cancer in patients with non-viral hepatitis. Whether diabetes mellitus is the cause of liver cancer and related pathogenesis remain unknown. The article reviews recent large-sample cohort studies and confirms that diabetes mellitus increases the incidence rate of liver cancer and affects its prognosis. This article also investigates the association of hepatitis C,obesity,and nonalcoholic fatty liver disease with diabetes mellitus and liver cancer and finds that insulin resistance and activation of chronic inflammatory factors may be involved in the generation and proliferation of cancer cells. This article elaborates on the influence of anti-insulin resistance drugs on the development and progression of liver cancer and points out that diabetes mellitus may be the cause of liver cancer. Effective control of insulin resistance can help to reduce the development and progression of diabetes-associated liver cancer.