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Copyright ©2014 Baishideng Publishing Group Inc.
World J Gastroenterol. Jul 28, 2014; 20(28): 9217-9228
Published online Jul 28, 2014. doi: 10.3748/wjg.v20.i28.9217
Table 1 Results of a meta-analysis of hepatocellular carcinoma and metabolic syndrome, type 2 diabetes mellitus and obesity in 2012
Ref.DatabaseResults
Esposito et al[13]43 articles, including 38940 cases of cancerMetabolic syndrome was associated with liver cancer (relative risk 1.43, P < 0.0001), especially in Asian populations
Chen et al[14] (2012)26 prospective studies, including 25337 primary liver cancer casesOverweight subjects have an increased risk of primary liver cancer of 1.48 (95%CI: 1.31-1.67), and obese subjects of 1.83 (95%CI: 1.59-2.11)
Tanaka et al[15] (2012)9 cohort studies on Japanese populationsOverweight/obese individuals had a relative risk of 1.74 (95%CI: 1.33-2.28) for developing liver cancer
Wang et al[16] (2012)17 case-control studies and 32 cohort studiesStatistically significant increased risk of HCC prevalence among diabetic individuals (RR = 2.31, 95%CI: 1.87-2.84). The pooled risk estimate of 17 case-control studies (OR = 2.40, 95%CI: 1.85-3.11) was slightly higher than that of 25 cohort studies (RR = 2.23, 95%CI: 1.68-2.96). Metformin treatment was potentially protective. Long duration of diabetes and sulfonylureas or insulin treatment possibly increased HCC risk. Increased risk of HCC mortality (RR = 2.43, 95%CI: 1.66-3.55) for individuals with (vs without) diabetes
Wang et al[17] (2012)25 cohort studiesAmong these, 18 studies showed that DM was associated with an increased incidence of HCC (SRRs = 2.01, 95%CI: 1.61-2.51), compared with individuals without DM
There was a statistically significant heterogeneity among these studies (Q = 136.68, P < 0.001, I(2) = 87.6%). Analyses sub-grouped by controlling confounders revealed that the increased incidence of HCC was independent of geographic location, alcohol consumption, history of cirrhosis, or infections with hepatitis B (HBV) or hepatitis C virus (HCV). In addition, DM was also positively associated with HCC mortality (SRR = 1.56; 95%CI: 1.30-1.87)