Diabetes, metabolic syndrome increase risk for HCC

HONOLULU — Researchers from Penn State Milton S. Hershey Medical Center found that diabetes and metabolic syndrome were independent risk factors for the development of hepatocellular carcinoma, according to data presented during a plenary session at ACG 2015.

Allison Kasmari, MD, and colleagues analyzed data from 7,473 patients with HCC from an insurance claims database known as MarketScan. These patients were matched for age, sex, gender and medical comorbidities with a control group of 22,110 patients. The researchers conducted case analyses in separate groups of patients, including those with HCC and HCV, with and without diabetes, and diabetes alone.

“In order to optimize early detection of HCC, we must understand the risk factors,” Kasmari said during her presentation. “The aim of the study was to determine the risk of HCC in patients with diabetes and other components of the metabolic syndrome.”

Overall, patients with only diabetes had an odds ratio (OR) of 1.353, which indicated a 1.353 increased risk for developing HCC (95% CI, 1.249-1.465). Patients with hypertension had a 1.229 risk of developing HCC (95% CI, 1.155-1.308), while hyperlipidemia appeared to be protective against HCC with an OR of 0.885 (95% CI, 0.831-0.942).

Among patients with diabetes, metformin (OR 0.706, 95% CI, 0.632-0.788) and cholesterol medications (OR 0.645, 95% CI, 0.601-0.692) were significantly protective against HCC, while insulin represented an increased risk of developing HCC when compared to diabetes alone (OR 1.640, 95% CI, 1.482-1.814). Sulfonylureas had no significant effect on HCC risk.

It was observed in patients with diabetes, regardless of HCV status, that hyperlipidemia (HL) was associated with a 2.3 times increased risk of HCC. Patients with diabetes, hypertension and HCV had an increased risk for HCC compared with patients with diabetes and hypertension without HCV (4.590 vs. 3.399).

According to Kasmari’s presentation, patients with diabetes with hypertension and HCV had an OR of 4.590 (95% CI, 3.705-5.662). In those without HCV, the risk was still high with an OR of 3.399.

“HCV represented the largest risk factor associated with a single risk factor for HCC,” Kasmari said. “Diabetes and hypertension represented individual increased risk for HCC."

– by Melinda Stevens

Reference: 

Kasmari A, et al. Abstract 1. Presented at: ACG; Oct. 16-21, 2015; Honolulu.

Disclosures: The researchers report no relevant financial disclosures.

Editor's Note: This story has been updated to reflect current data.