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Antidiabetic therapy and increased risk of hepatocellular carcinoma in chronic liver disease 被引量:23
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作者 Valter Donadon Massimiliano Balbi +8 位作者 Michela Ghersetti silvia grazioli Antonio Perciaccante Giovanni Della Valentina Rita Gardenal Maria Dal Mas Pietro Casarin Giorgio Zanette Cesare Miranda 《World Journal of Gastroenterology》 SCIE CAS CSCD 2009年第20期2506-2511,共6页
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 possibl... 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, 233% 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 confirms 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 meUitus, our data shows a direct association of HCC with insulin and sulphanylureas treatment and an inverse relationship with metformin therapy. 展开更多
关键词 Hepatocellular carcinoma Type 2 diabetes mellitus INSULIN Sulphanylureas METFORMIN
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