title: Effect of type 2 diabetes mellitus on the risk for hepatocellular carcinoma in chronic liver diseases: a meta-analysis of cohort studies.
abstract: Questions remain about the relationship between type 2 diabetes mellitus (type 2 DM) and the risk of hepatocellular carcinoma (HCC), especially in patients with chronic liver diseases. We carried out a meta-analysis of cohort studies to explore these issues. We searched PubMed and EMBASE for studies on the association between type 2 DM and the risk of HCC through 30 September 2013. We included patients with chronic liver diseases. Summary relative risks with their corresponding 95% confidence intervals (CIs) were calculated using a random-effects model. A total of 21 cohort studies with 24 reports were included in our analysis. After a median duration of follow-up of 6.4 years, a total of 2528 HCC cases were identified in 35 202 participants. The summary relative risk of HCC with type 2 DM was 1.86 (95% CI 1.49-2.31) for patients with chronic liver disease, 1.90 (95% CI 1.37-2.63) for patients with hepatitis C virus infection, 1.93 (95% CI 1.35-2.76) for patients with cirrhosis, and 1.69 (95% CI 0.97-2.92) for patients with hepatitis B virus infection. Subgroup analyses indicated that the positive associations were independent of geographic location, duration of follow-up, and confounding factors such as smoking, alcohol use, and body mass index (BMI). Hepatitis C virus-infected or cirrhotic patients with the concomitant presence of type 2 DM would have a higher risk of developing HCC than those without DM. Therefore, these patients require more active monitoring of the development of HCC.
authors.affiliation: Departments of aTraditional Chinese Medicine bPharmacy, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, China.
authors.forename: Junming
authors.initials: J
authors.lastname: Chen
authors.forename: Yonglong
authors.initials: Y
authors.lastname: Han
authors.forename: Chunwei
authors.initials: C
authors.lastname: Xu
authors.forename: Tiegang
authors.initials: T
authors.lastname: Xiao
authors.forename: Bing
authors.initials: B
authors.lastname: Wang
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000453:epidemiology*; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D019694:Hepatitis B, Chronic / Q000453:epidemiology*; D019698:Hepatitis C, Chronic / Q000453:epidemiology*; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology*; D008107:Liver Diseases / Q000453:epidemiology; D008113:Liver Neoplasms / Q000453:epidemiology*; D012307:Risk Factors