Association between Diabetes Mellitus and Hepatocellular Carcinoma: Results of a Hospital- and Community-based Case-control Study

Abstract

The present study was performed to investigate the relationship between diabetes mellitus (DM) and primary hepatocellular carcinoma (HCC). Incident HCC cases were recruited in Kyushu, Japan. Ethnicity-, age-, gender-, residence-matched hospital controls and community controls were collected. Information on viral hepatitis B (HB5Ag) or viral hepatitis C infection, history of blood transfusion, past histories including DM, amount of drinking or smoking, and genotypes of alcohol metabolizing enzymes was collected. Associations between these items and HCC were analyzed multivariately by conditional logistic regression analysis. Two hundred and twenty two (177 males and 45 females) case-control sets were completed between July 1995 and June 2000. Since hospital controls turned out to be a biased one or those sampled from a DM-prone population, a multivariate analysis was performed for the HOC-community controls sets, and it yielded significantly elevated odds ratio (OR)s due to past histories of DM (2.522; 95% Confidence Interval (CI)=1 .267-5.020), blood transfusion (1.747; 1.136-2.689), and unit increment of alcohol consumption (1.358; 1.096-1.684) for males. The same analyses of the HOC-community controls sets for females, revealed an elevated but not statistically significant OR due to past histories of DM (4.195; 0.808-21.805). A multivariate analysis revealed that DM might be a risk factor for HOC.

Cigarette smoking as a risk factor for the development of and mortality from hepatocellular carcinoma: An updated systematic review of 81 epidemiological studies

“…Of the 102 possibly eligible studies after the initial screening, the full text search that ensued resulted in removal of 21 studies. Hence, 81 studies were included in the systematic review . Seventy‐two studies assessed the association between smoking and risk of development of HCC and nine studies assessed the association between smoking and the risk of mortality in HCC patients.…”

The prevalence of occult hepatitis B virus infection in type 2 diabetes mellitus patients

“…These data raise concerns that the prevalence of occult HBV may be more common among type 2 diabetes mellitus (DM) patients because of the abnormalities of the immune system. Additionally, increased HCC prevalence in diabetic population has been reported and the associated steatohepatitis has been suggested as a causative factor [10,11]. It is plausible that the increased occult HBV prevalence among DM patients may imply a possible direct or an additive role with steatohepatitis in the development of HCC.…”

A rare case report of mandibular metastasis of hepatocellular carcinoma: autopsy, immunohistochemical, and ultrastructural examination with literature review

“…It is unknown whether the patient was a heavy alcohol drinker, although autopsy findings showed liver cirrhosis. The present case did not show steatohepatitis, while the previous studies suggested that a past history of diabetes mellitus might be a risk factor for hepatitis, cirrhosis and HCC, and the earlier patients were negative for all serological markers of hepatitis B and C virus infection (15)(16)(17). From these considerations, it is surmised that the HCC in the present case probably progressed from diabetes through hepatitis and cirrhosis.…”