Diabetes increases the risk of
hepatocellular carcinoma
last updated April 19, 2007
Diabetes increases the risk of
hepatocellular carcinoma
Diabetes is associated with a two-to-three-
fold increase in the risk of liver cancer
(hepatocellular carcinoma; HCC), regardless
of the presence of other major risk factors -
Hashem El-Serag, Houston Veteran Affairs
Medical Center, Texas.
Dr. El-Serag and his group used the
Surveillance Epidemiology and End-Results
Program (SEER)-Medicare linked database
to identify patients aged 65 years and older
diagnosed with HCC and randomly selected
non-cancer controls between 1994 and
1999. They searched inpatient and
outpatient claims files for diagnostic codes
indicative of diabetes, hepatitis C virus
(HCV), hepatitis B virus (HBV), alcoholic liver
disease, and haemochromatosis. In multiple
logistic regression analyses, they found that
diabetes was associated with a threefold
increase in the risk of HCC. In a subset of
patients without major risk factors, the
adjusted odds ratio for diabetes declined but
remained significant (diabetics have higher
odds of getting the disease). In addition, they
detected a significant positive interaction
between HCV and diabetes. [Gut. 2005 Apr;
54(4):533-9].
Case reports have shown progression of
nonalcoholic fatty liver disease to cirrhosis
and hepatocellular carcinoma. And, both
obesity and diabetes are frequently
associated with nonalcoholic fatty liver
disease [Caldwell SH et al, Obesity and
hepatocellular carcinoma, Gastroenterology.
2004 Nov;127(5 Suppl 1):S97-103]
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