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Risk of hepatocellular carcinoma in diabetic patients and risk reduction associated with anti-diabetic therapy: a population-based cohort study.
Am J Gastroenterol. 2012 Jan; 107(1):46-52.AJ

Abstract

OBJECTIVES

Using population-based representative insurance claims data, the risk of developing hepatocellular carcinoma (HCC) among diabetes mellitus (DM) patients, as well as whether DM medications alter the risk of developing HCC were investigated.

METHODS

From the Taiwan National Health Insurance Research Database, 19,349 newly diagnosed DM patients 20 years and older and 77,396 comparison subjects without DM were identified from claims from 2000 to 2005. The incidences of HCC at the end of 2008 and the risks associated with hepatitis B and hepatitis C were determined. Whether metformin and thiazolidinediones reduce the risk of developing HCC was also measured.

RESULTS

The incidence of HCC was twice higher in the DM group compared with the non-DM group (21.0 vs. 10.4 per 10,000 person-years), with an adjusted hazard ratio (HR) of 1.73 (95% confidence interval (CI)=1.47-2.03) using multivariable Cox proportional hazard regression. Male sex, cirrhosis, hepatitis B, and hepatitis C were significant independent factors that predict HCC, with HRs of 2.32, 8.65, 2.52, and 5.61, respectively. In the stratified analysis, the HR increased to 72.4 (95% CI=42.9-122) among patients with DM, cirrhosis, and hepatitis C. HCC risk reduction was greater for diabetics taking metformin than those taking thiazolidinediones (51 vs. 44% reduction).

CONCLUSIONS

Comorbidity with cirrhosis and/or hepatitis appears to be associated with an extremely increased risk of developing HCC among DM patients. These high-risk patients should be closely monitored for HCC. The use of metformin or thiazolidinediones may reduce the risk of developing HCC.

Authors+Show Affiliations

Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22085817

Citation

Lai, Shih-Wei, et al. "Risk of Hepatocellular Carcinoma in Diabetic Patients and Risk Reduction Associated With Anti-diabetic Therapy: a Population-based Cohort Study." The American Journal of Gastroenterology, vol. 107, no. 1, 2012, pp. 46-52.
Lai SW, Chen PC, Liao KF, et al. Risk of hepatocellular carcinoma in diabetic patients and risk reduction associated with anti-diabetic therapy: a population-based cohort study. Am J Gastroenterol. 2012;107(1):46-52.
Lai, S. W., Chen, P. C., Liao, K. F., Muo, C. H., Lin, C. C., & Sung, F. C. (2012). Risk of hepatocellular carcinoma in diabetic patients and risk reduction associated with anti-diabetic therapy: a population-based cohort study. The American Journal of Gastroenterology, 107(1), 46-52. https://doi.org/10.1038/ajg.2011.384
Lai SW, et al. Risk of Hepatocellular Carcinoma in Diabetic Patients and Risk Reduction Associated With Anti-diabetic Therapy: a Population-based Cohort Study. Am J Gastroenterol. 2012;107(1):46-52. PubMed PMID: 22085817.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk of hepatocellular carcinoma in diabetic patients and risk reduction associated with anti-diabetic therapy: a population-based cohort study. AU - Lai,Shih-Wei, AU - Chen,Pei-Chun, AU - Liao,Kuan-Fu, AU - Muo,Chih-Hsin, AU - Lin,Cheng-Chieh, AU - Sung,Fung-Chang, Y1 - 2011/11/15/ PY - 2011/11/17/entrez PY - 2011/11/17/pubmed PY - 2012/2/22/medline SP - 46 EP - 52 JF - The American journal of gastroenterology JO - Am J Gastroenterol VL - 107 IS - 1 N2 - OBJECTIVES: Using population-based representative insurance claims data, the risk of developing hepatocellular carcinoma (HCC) among diabetes mellitus (DM) patients, as well as whether DM medications alter the risk of developing HCC were investigated. METHODS: From the Taiwan National Health Insurance Research Database, 19,349 newly diagnosed DM patients 20 years and older and 77,396 comparison subjects without DM were identified from claims from 2000 to 2005. The incidences of HCC at the end of 2008 and the risks associated with hepatitis B and hepatitis C were determined. Whether metformin and thiazolidinediones reduce the risk of developing HCC was also measured. RESULTS: The incidence of HCC was twice higher in the DM group compared with the non-DM group (21.0 vs. 10.4 per 10,000 person-years), with an adjusted hazard ratio (HR) of 1.73 (95% confidence interval (CI)=1.47-2.03) using multivariable Cox proportional hazard regression. Male sex, cirrhosis, hepatitis B, and hepatitis C were significant independent factors that predict HCC, with HRs of 2.32, 8.65, 2.52, and 5.61, respectively. In the stratified analysis, the HR increased to 72.4 (95% CI=42.9-122) among patients with DM, cirrhosis, and hepatitis C. HCC risk reduction was greater for diabetics taking metformin than those taking thiazolidinediones (51 vs. 44% reduction). CONCLUSIONS: Comorbidity with cirrhosis and/or hepatitis appears to be associated with an extremely increased risk of developing HCC among DM patients. These high-risk patients should be closely monitored for HCC. The use of metformin or thiazolidinediones may reduce the risk of developing HCC. SN - 1572-0241 UR - https://www.unboundmedicine.com/medline/citation/22085817/Risk_of_hepatocellular_carcinoma_in_diabetic_patients_and_risk_reduction_associated_with_anti_diabetic_therapy:_a_population_based_cohort_study_ L2 - https://Insights.ovid.com/pubmed?pmid=22085817 DB - PRIME DP - Unbound Medicine ER -