title: Combination Therapy of Metformin and Statin May Decrease Hepatocellular Carcinoma Among Diabetic Patients in Asia.
abstract: Previous studies have shown that metformin or statins may decrease hepatocellular carcinoma (HCC) in diabetic patients. Accordingly, this article evaluates whether combination therapy may further reduce HCC. Newly diagnosed type 2 diabetes mellitus (DM) patients, excluding those with history of malignancy prior to the date of DM diagnosis, were recruited to a DM cohort. DM patients developed HCC as the cancer cohort and the date for HCC diagnosis as index date. Non-cancer cohort was frequency matched with 4:1 according to age, sex, DM-year, and index date as case group from DM cohort. Patients who were treated with statins showed a 63% decreased risk of HCC (odds ratio [OR] = 0.37; 95% confidence interval [CI] = 0.27-0.49). Patients who consumed simvastatin, atorvastatin, or rosuvastatin significantly decreased risk for HCC (OR = 0.32, 0.31, and 0.22; 95% CI = 0.18-0.58, 0.19-0.52, and 0.08-0.61, respectively). Metformin combinations with simvastatin, atorvastatin, or rosuvastatin may decrease HCC (OR = 0.30, 0.30, and 0.24; 95% CI = 0.15-0.59, 0.16-0.54, and 0.08-0.70, respectively). The comorbidities for HCC were decreased by consuming simvastatin and atorvastatin (OR = 0.31 and 0.29; 95% CI = 0.14-0.67 and 0.15-0.57, respectively). Only combination therapy of metformin and simvastatin may significantly decreased HCC comorbidities (OR = 0.26; 95% CI = 0.11-0.60) in our study. In Asia, not all metformin combinations with statins may reduce the incidence of HCC and not all of this kind of combination therapy may decrease the HCC comorbidities.
authors.affiliation: From the School of Medicine and Public Health, Chung Shan Medical University, Taichung, Taiwan (H-HC); Division of Metabolism and Endocrinology, Changhua Christian Hospital, Changhua, Taiwan (H-HC); Division of Metabolism and Endocrinology, Nantou Christian Hospital, Nantou, Taiwan (H-HC); Department of Nuclear Medicine, E-DA Hospital, Kaohsiung, Taiwan (M-CL); Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan (C-HM, F-CS); Asia University, Taichung, Taiwan (S-YY); Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine, Taichung, Taiwan (F-CS, C-HK); and Department of Nuclear Medicine and PET Center China Medical University Hospital, Taichung, Taiwan (C-HK).
authors.forename: Hsin-Hung
authors.initials: HH
authors.lastname: Chen
authors.forename: Ming-Chia
authors.initials: MC
authors.lastname: Lin
authors.forename: Chih-Hsin
authors.initials: CH
authors.lastname: Muo
authors.forename: Su-Yin
authors.initials: SY
authors.lastname: Yeh
authors.forename: Fung-Chang
authors.initials: FC
authors.lastname: Sung
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
mesh_terms: D000368:Aged; D001208:Asia / Q000453:epidemiology; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000517:prevention & control*; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000453:epidemiology; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D008113:Liver Neoplasms / Q000453:epidemiology / Q000517:prevention & control*; D008297:Male; D008687:Metformin / Q000008:administration & dosage* / Q000627:therapeutic use; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008687:Metformin