标题：Diabetes mellitus and risk of hepatocellular carcinoma: a systematic review and meta-analysis
作者：Wang, Ping; Kang, Donghong; Cao, Wei; Wang, Yan; Liu, Zhiwen
作者机构：[Wang, Ping; Kang, Donghong; Cao, Wei] Shandong Univ, Dept Endocrinol, Qianfoshan Hosp, Jinan 250014, Peoples R China.; [Wang, Ping; Kang, Donghong; 更多
通讯作者地址：[Kang, DH]Shandong Univ, Dept Endocrinol, Qianfoshan Hosp, 16766 Jingshi Rd, Jinan 250014, Peoples R China.
来源：DIABETES-METABOLISM RESEARCH AND REVIEWS
关键词：diabetes; hepatocellular carcinoma; case-control; cohort; meta-analysis
摘要：Studies of diabetes and hepatocellular carcinoma (HCC) yielded inconsistent findings. This meta-analysis was conducted to examine the association between diabetes and risk of HCC. Studies were identified by searching PUBMED and MEDLINE database up to February 2011. Pooled risk estimates were calculated using the random-effects model. Potential sources of heterogeneity were explored by subgroup analyses. A total of 17 case-control studies and 32 cohort studies were included in the meta-analysis. The combined risk estimate of all studies showed a statistically significant increased risk of HCC prevalence among diabetic individuals (RR = 2.31, 95% CI: 1.87-2.84). The pooled risk estimate of 17 case-control studies (OR = 2.40, 95% CI: 1.85-3.11) was slightly higher than that from 25 cohort studies (RR = 2.23, 95% CI: 1.68-2.96). Metformin treatment was potentially protective. On the contrary, long duration of diabetes and sulfonylureas or insulin treatment possibly increase HCC risk. Also meta-analysis of 7 cohort studies found a statistically significant increased risk of HCC mortality (RR = 2.43, 95% CI: 1.66-3.55) for individuals with (versus without) diabetes. This meta-analysis shows that diabetes is associated with moderately increased risk of HCC prevalence, as well as HCC mortality. Considering the rapidly increasing prevalence of diabetes mellitus, the study underlines the need for cancer prevention in diabetic individuals. Further investigation is needed to focus on the potential mechanism for the pathogenesis of HCC and the link between HCC and different types, severity, treatment and duration of diabetes. Copyright (C) 2011 John Wiley & Sons, Ltd.