Diabetes and Insulin Therapy, but Not Metformin, Are Related to Hepatocellular Cancer Risk

Luca Miele, Gian Ludovico Rapaccini, Antonio Gasbarrini, Stefania Boccia, Antonio Grieco, Cristina Bosetti, Federica Turati, Carlo La Vecchia

Risultato della ricerca: Contributo in rivistaArticolo in rivista

22 Citazioni (Scopus)


Introduction. Metabolic conditions, including type 2 diabetes, have been related to hepatocellular carcinoma (HCC) risk. We have further analyzed the role of diabetes and antidiabetic treatments on HCC. Methods. Data derived from a hospital-based case-control study (Italy, 2005-2012) on 224 HCC patients and 389 controls. Odds ratios (ORs) were estimated using multiple logistic regression models. Results. Sixty-nine (30.9%) cases versus 52 (13.5%) controls reported a diabetes diagnosis, corresponding to a multivariate OR of 2.25 (95% confidence interval, CI = 1.42-3.56). A stronger excess risk emerged for a longer time since diabetes diagnosis (OR = 2.96 for <10 years and 5.33 for ≥10 years). Oral therapies were inversely, though not significantly, related to HCC risk, OR being 0.44 for metformin and 0.88 for sulfonylureas; conversely, insulin was nonsignificantly directly associated (OR = 1.90). Compared to nondiabetic subjects who were never smokers, those who were diabetics and ever smokers had an OR of 6.61 (95% CI 3.31-13.25). Conclusion. Our study confirms an over 2-fold excess HCC risk in diabetics, with a stronger excess risk in diabetic subjects who are also tobacco smokers. Metformin may decrease the risk of HCC, whereas insulin may increase the risk.
Lingua originaleEnglish
pagine (da-a)570356-570356
Numero di pagine1
RivistaGastroenterology Research and Practice
Stato di pubblicazionePubblicato - 2015


  • diabetes and insulin
  • metformin


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