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Impact of metformin use on risk and mortality of hepatocellular carcinoma in diabetes mellitus
Institution:1. Department of Hepatic Surgery, The Third Affiliated Hospital of Naval Medical University, 201805 Shanghai, China;2. Second department of biliary tract, The Third Affiliated Hospital of Naval Medical University, 201805 Shanghai, China;3. Department of special treatment, The Third Affiliated Hospital of Naval Medical University, 201805 Shanghai, China;4. Department of Oncology Biotherapy, The Third Affiliated Hospital of Naval Medical University, No. 700 North Moyu road, Jiading district, 201805 Shanghai, China;1. Department of Internal Medicine IV, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany;2. Interdisciplinary Endoscopy Center, Department of Internal Medicine IV, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany;1. MRI Department, the First Affiliated Hospital of Henan University of Chinese Medicine, No 19 Renmin Road, Zhengzhou, Henan, China;2. Department of Radiology, Gold Coast University Hospital, Queensland, Australia;1. Department of Gastroenterology, the Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China;2. Department of Pathology, the Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
Abstract:BackgroundThe views regarding the associations between metformin use and hepatocellular carcinoma (HCC) among diabetes mellitus (DM) patients are divisive. Thus we summarized all available published studies evaluating the relationship between metformin therapy and HCC survival and risk, and aim to conduct an updated meta-analysis study to more accurately clarify the association.MethodsWe searched for articles regarding impact of metformin use on risk and mortality of HCC in DM and published before April 2021 in databases (PubMed and Web of Science). We used STATA 12.0 software to compute odds ratios (ORs)/relative risks (RRs) or hazard ratios (HRs) and their 95% confidence intervals (CIs) to generate a computed effect size and 95% CI.ResultsThe present study showed that metformin use was associated with a decreased risk of HCC in DM with a random effects model (OR/RR = 0.59, 95% CI 0.51–0.68, I2 = 96.5%, p < 0.001). In addition, the study indicated that metformin use was associated with a decreased all-cause mortality of HCC in DM with a random effects model (HR = 0.74, 95% CI 0.66–0.83, I2 = 49.6%, p = 0.037).ConclusionIn conclusion, our studies support that the use of metformin in DM patients is significantly associated with reduced risk and all-cause mortality of HCC. And more prospective studies focusing on the metformin therapy as a protective factor for HCC are needed to verify the accuracy of the findings.
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