糖尿病及其降糖药物与肝癌发生和发展的关系

Relationship between diabetes,its hypoglycemic drugs and the occurrence and development of liver cancer

双胍类、噻唑烷二酮类可减少糖尿病患者罹患肝癌的风险,有助于改善肝癌合并糖尿病患者的预后,而胰岛素及胰岛素类似物或磺脲类药物则可能增加糖尿病患者罹患肝癌的风险,且与预后不良相关;胰高血糖素样肽-1(GLP-1)受体激动剂、钠—葡萄糖协同转运蛋白2(SGLT-2)抑制剂有助于改善肝脂肪变性和纤维化,有望成为非酒精性脂肪性肝炎(NASH)和非酒精性脂肪性肝病(NAFLD)的治疗药物,从而降低糖尿病患者肝癌的发生风险,延缓肝癌的进展。本文对临床常用降糖药物与肝癌发生和发展的关系及相关机制研究进行综述,旨在为糖尿病合并肝癌患者的降糖药物选择提供参考依据。

Biguanides and thiazolidinediones can reduce the risk of liver cancer in diabetic patients and help improve the prognosis of patients with liver cancer and diabetes,while insulin and insulin similitude or sulfonylureas may increase the risk of liver cancer in diabetic patients and are associated with poor prognosis.Glucagonlike peptide-1(GLP-1)receptor agonists and sodium-glucose cotransporter protein-2(SGLT-2)inhibitors help improve hepatic steatosis and fibrosis and are expected to become therapeutic agents for non-alcoholic steatohepatitis(NASH)and non-alcoholic fatty liver disease(NAFLD),thereby reducing the risk of liver cancer in diabetic patients and delay the progression of liver cancer.This review summarizes the relationship between commonly used clinical hypoglycemic drugs and the occurrence and development of liver cancer as well as the related mechanisms,aiming to provide reference for the selection of hypoglycemic drugs for patients with diabetes and liver cancer.