Epidemiology

Hepatocellular carcinoma patients have high prevalence of diabetes

Last Updated: 2008-11-14 19:31:45 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Patients with hepatocellular carcinoma (HCC) have a significantly higher prevalence of type 2 diabetes mellitus (DM) compared to the general population, according to findings from a case-control study conducted in Italy.

"The association of type 2 diabetes mellitus (DM2) ... with hepatocellular carcinoma (HCC) has been long suspected," Dr. Valter Donadon, at Pordenone Hospital, and co-authors note in the October 7 issue of the World Journal of Gastroenterology. "However, the temporal relationship between onset of diabetes and development of HCC, and the clinical and metabolic characteristics of patients with DM2 and HCC have not been well examined."

Their study included 465 consecutive Caucasian HCC patients and 490 age- and sex-matched controls.

Overall, 145 hepatocellular carcinoma patients (31%) and 62 control cases (13%) had type 2 diabetes (odds ratio 3.1). Moreover, the authors note, diabetes had been diagnosed at least 6 months prior to the diagnosis of hepatocellular carcinoma in 84% of cases, suggesting that diabetes may be a cause rather than a consequence of liver cancer.

Men with DM and HCC were more likely to be treated with insulin than male diabetics in the control group (38% vs 18%, p = 0.009), leading the researchers to recommend "close surveillance for HCC in patients with chronic liver disease and DM2, particularly (among) males and (those) treated with insulin."

They also advise that metabolic control be attempted with insulin-sensitizers, such as metformin and glitazones, in preference to insulin or oral secretogogues.

World J Gastroenterol 2008;14:5695-5700.