Diabetes and hepatocellular carcinoma: A pathophysiological link and pharmacological management

Singh, Munshi; Das, Bhrigu Kumar; Choudhary, Sandeep; Gupta, Deepak; Patil, U. K.

doi:10.1016/j.biopha.2018.06.095

Cited by 59 publications

(45 citation statements)

References 113 publications

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“…The distribution of treatmet options applied to HCC patients are shown in figure 2. Discussion:-DM has been reported in many studies as a risk factor for liver cancer (7). As known, fibrosis caused by chronic HCV infection becomes more noticeable in the presence of diabetes (17).…”

Section: Results:-mentioning

confidence: 84%

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Assessment of the Relationship Between the Monitoring Results of Patients With Viral Hepatitis-Related Hepatocellular Carcinoma and Type 2 Diabetes Mellitus.

Öztürk¹

2019

IJAR

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Chronic hepatitis B, chronic hepatitis C, hepatocellular carcinoma. Background: Among the etiological factors of hepatocellular carcinoma (HCC), which is the most frequently encountered cause of primary liver cancers, viral hepatitis cases are at the top. The relationship between glucose anomalies and HCC development in especially patients with viral hepatitis C and B infections is still a topic of curiosity. In this study, we aimed to assess the potential relationship between the chronic hepatitis C and B infections (HBV and HCV) in monitoring of HCC patients and type 2 diabetes mellitus (DM) comorbidity. Material and Method: A total of consecutive 51 HCC patients with a mean age of 69.98±11.92 years were enrolled in this study. The Barcelona-Clinic Liver Cancer (BCLC) criteria were used for staging the patients with HCC. HBsAg seroprevalence with the Anti-HCV antibody was studied with the ELISA method. The patients were grouped based on presence of diabetes, and the relationships between disease stages and viral etiological factors were statistically analyzed. Results: In patients with HCC, DM prevalence was 41.2%. 55.6% of Chronic hepatitis C patients and only 33.3% of chronic hepatitis B patients had diagnoses of DM (p=0.107). According to the BCLC stages in the patients, the DM rates at A, B, and C were 40%, 45.5% and 50% respectively (p<0.05). Conclusion: Blood sugar regulation in chronic viral hepatitis patients with DM may contribute to reduction of HCC risk.

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Section: Results:-mentioning

confidence: 84%

“…The role played by DM in the carcinogenesis of HCC is not yet completely clear. In addition to this, it is proposed that hyperglycemia, hyperinsulinemia, insulin resistance and increased IGF-1 activation are effective in the pathophysiology of HCC development by their strong mitogenic and anti-apoptotic effects (7).…”

mentioning

confidence: 99%

Assessment of the Relationship Between the Monitoring Results of Patients With Viral Hepatitis-Related Hepatocellular Carcinoma and Type 2 Diabetes Mellitus.

Öztürk¹

2019

IJAR

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“…Liu Tong's study showed that although the fasting blood glucose level increased, it did not meet the diagnostic criteria of diabetes; however, the risk of HCC still increased signi cantly. At present, the relationship between the early postoperative recurrence of HCC and hyperglycemia is still controversial, both at home and abroad [23][24][25][26][27]..…”

Section: Discussionmentioning

confidence: 99%

Hyperglycemia-Associated Early Hepatocellular Carcinoma Recurrence After Open Radical Hepatectomy

Liu¹,

Xie²,

Zhang³

et al. 2020

Preprint

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BackgroundWe investigated the impact of elevated glucose levels on the early recurrence of hepatocellular carcinoma (HCC)after open radical hepatectomy.MethodsThis retrospective cohort study analyzed. The clinical data of 112 patients with hepatocellular carcinoma who underwent open radical hepatectomy from January 2013 to December 2014 at the Affiliated Hospital of Qingdao University. After radical resection of the hepatocellular carcinoma, 86 patients with an average fasting blood glucose(FBG) level of 3.9–6.1 mmol/L and 26 patients with an FBG level ≥ 6.1 mmol/L were divided into the normal group and hyperglycemic group, respectively. The recurrence rate of hepatocellular carcinoma was compared between the two groups 1 and 2 years after the operation.ResultsThe postoperative 1- and 2-year recurrence rates of HCC were 19.8% (17/86) and 33.7% (29/86), respectively, in the normal group and42.3% (11/26) and 61.5% (16/26), respectively, in the hyperglycemic group; there were significant differences between the two groups (χ2 = 6.719,P = 0.01;χ2 = 6.427༌P = 0.011). The univariate analysis showed that FBG, history of alcohol drinking, extent of hepatectomy, histopathological differentiation, maximal tumor diameter, satellite lesion, and the postoperative adjuvant treatment were risk factors affecting the tumor-free survival rate after open radical resection of hepatocellular carcinoma (P < .05).The results of the multivariate analysis showed that FBG levels ≥ 6.1 mmol/L, low histopathological differentiation, and no postoperative adjuvant treatment were independent risk factors affecting tumor-free survival rate after radical resection of hepatocellular carcinoma (P < .05).ConclusionAn elevated FBG level has a stimulating effect on the early recurrence of tumor after open radical resection of hepatocellular carcinoma. Therefore, postoperative monitoring and blood glucose control may facilitate a decrease in the early recurrence rate in patients with hepatocellular carcinoma.

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“…Meta-analyses have shown that diabetes is associated with HCC independent of viral hepatitis in which diabetic patients show 2-3 fold greater risks in developing HCC compared with non-diabetic controls (43). The pathophysiological conditions such as hyperglycemia, hyperinsulinemia, insulin resistance, and activation of insulin-like growth factor signaling pathways provide a strong association for diabetes to be the risk factor in the pathogenesis of HCC (5,44). Obesity, a pathological state characterized by insulin resistance, hyperinsulinemia, and inflammation is also closely associated with HCC (45).…”

Section: Metabolic Syndrome and Hccmentioning

confidence: 99%

Etiology of Hepatocellular Carcinoma: Special Focus on Fatty Liver Disease

2020

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Hepatocellular Carcinoma (HCC) is a highly aggressive cancer with mortality running parallel to its incidence and has limited therapeutic options. Chronic liver inflammation and injury contribute significantly to the development and progression of HCC. Several factors such as gender, age, ethnicity, and demographic regions increase the HCC incidence rates and the major risk factors are chronic infection with hepatitis B virus (HBV) or hepatitis C virus (HCV), carcinogens (food contaminants, tobacco smoking, and environmental toxins), and inherited diseases. In recent years evidence highlights the association of metabolic syndrome (diabetes and obesity), excessive alcohol consumption (alcoholic fatty liver disease), and high-calorie intake (nonalcoholic fatty liver disease) to be the prime causes for HCC in countries with a westernized sedentary lifestyle. HCC predominantly occurs in the setting of chronic liver disease and cirrhosis (80%), however, 20% of the cases have been known in patients with non-cirrhotic liver. It is widely believed that there exist possible interactions between different etiological agents leading to the involvement of diverse mechanisms in the pathogenesis of HCC. Understanding the molecular mechanisms of HCC development and progression is imperative in developing effective targeted therapies to combat this deadly disease. Noteworthy, a detailed understanding of the risk factors is also critical to improve the screening, early detection, prevention, and management of HCC. Thus, this review recapitulates the etiology of HCC focusing especially on the nonalcoholic fatty liver disease (NAFLD)- and alcoholic fatty liver disease (AFLD)-associated HCC.

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Diabetes and hepatocellular carcinoma: A pathophysiological link and pharmacological management

Cited by 59 publications

References 113 publications

Assessment of the Relationship Between the Monitoring Results of Patients With Viral Hepatitis-Related Hepatocellular Carcinoma and Type 2 Diabetes Mellitus.

Assessment of the Relationship Between the Monitoring Results of Patients With Viral Hepatitis-Related Hepatocellular Carcinoma and Type 2 Diabetes Mellitus.

Hyperglycemia-Associated Early Hepatocellular Carcinoma Recurrence After Open Radical Hepatectomy

Etiology of Hepatocellular Carcinoma: Special Focus on Fatty Liver Disease

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