DDW-Metformin Shows Dose-Dependent Risk Reduction of HCC in Patients With Diabetes

DGDispatch

Metformin Shows Dose-Dependent Risk Reduction of HCC in Patients With Diabetes: Presented at DDW
By Nancy A. Melville

SAN DIEGO -- May 25, 2012 -- Metformin shows a dose-dependent chemopreventive effect in reducing the risk of hepatocellular carcinoma (HCC) at a rate of about 7% per year, researchers said here at the Digestive Disease Week (DDW) 2012.

Metformin has been linked with HCC in past research involving patients with other conditions, said lead author Chun-Ying Wu, MD, Yang-Ming University in Taipei, Taiwan

"Previous studies have shown a relationship between HCC and metformin, and in a prospective cohort of cirrhotic patients with hepatitis C, metformin use was associated with significantly reduced HCC risk," he said on May 21.

Several mechanisms are believed to provide the benefit, Dr. Wu added. "Whereas insulin resistance plays a role in hepatic carcinogenesis via activation of the IGF-1 signalling axis and increased fat accumulation in hepatocytes, metformin has been shown to improve insulin sensitivity, inhibit hepatic gluconeogenesis and decrease glycogenolysis."

In the new study, the research team evaluated 97,430 patients diagnosed with HCC between 1997 and 2008 who were enrolled in Taiwan's National Health Insurance Research Database and 194,860 age, gender, and physician visit date-matched controls.

The patients with diabetes not using metformin showed the highest risk of HCC (adjusted odds ratio [OR] = 1.95). This was followed by patients with diabetes who rarely used metformin (OR = 1.74), and then by those who frequently used metformin (OR = 1.67) and those who regularly used metformin (OR = 1.56).

Each incremental year increase in metformin use resulted in a 6% to 7% reduction in the risk of HCC in patients with diabetes.

"In the nationwide population study, we found that use of metformin is associated with a decreased risk of HCC in diabetic patients in a dose-dependent manner," Dr. Wu concluded. "Using metformin in diabetic patients to decrease the risk of HCC should be recommended."

Digestive Disease Week 2012 is cosponsored by the American Association for the Study of Liver Diseases (AASLD), the American Gastroenterological Association (AGA), the American Society for Gastrointestinal Endoscopy (ASGE), and the Society for Surgery of the Alimentary Tract (SSAT).

[Presentation title: Metformin Decreases Hepatocellular Carcinoma Risk in a Dose-Dependent Manner: Population-Based and in Vitro Studies. Abstract 596]