Non-viral etiologies and hepatocellular carcinoma

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Date 2012/November/14

Title: Non-viral etiologies and hepatocellular carcinoma Running head: diabetes and hepatocellular carcinoma

Shih-Wei Lai, MD1,2_{; Kuan-Fu Liao, MD and MS}3,4,5

1_{School of Medicine, and}3_{Graduate Institute of Integrated Medicine, China Medical}

University, Taichung, Taiwan

2_{Department of Family Medicine, China Medical University Hospital, Taichung,}

Taiwan

4_{Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung,}

Taiwan

5_{Department of Health Care Administration, Central Taiwan University of Science}

and Technology, Taichung, Taiwan Corresponding author:

Kuan-Fu Liao, MD and MS

Department of Internal Medicine, Taichung Tzu Chi General Hospital, No.66, Sec. 1, Fongsing Rd., Tanzi District, Taichung City, 427, Taiwan

Phone: 886-4-2205-2121 Fax: 886-4-2203-3986

E-mail: [email protected]

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One paper of great interest published in Hepatol Res, Nagaoki et al. observed that 100 patients (48%) had diabetes mellitus and 125 patients (60%) had heavy alcohol consumption among 209 patients with non-hepatitis B and non-hepatitis C

hepatocellular carcinoma (HCC). Recently, Arase et al. reported that Type 2 diabetes could be associated with 1.73-fold increased risk of HCC (95 % CI = 1.30-2.30) and heavy alcohol consumption could be associated with 1.45-fold increased risk of HCC (95 % CI = 1.11-1.88) in chronic hepatitis C patients . By utilizing the Taiwan National Health Insurance database, we found that the hazard ratio of HCC was 1.73 among diabetic patients (95 % CI = 1.47-2.03) . To date, a growing body of evidence showed that metformin use could correlate with risk reduction of HCC . Further studies are needed to explore whether metformin has an absolute effect on HCC risk or a relative effect mediated by optimal glycemic control among diabetic patients. In our view, Nagaoki et al.’s study have provided valuable evidence that in addition to viral etiology, patients with non-viral etiologies, such as diabetes and heavy alcohol consumption, should also receive close follow-up for HCC development.

Conflict of Interest Statement: The authors disclose no conflicts of interest.

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REFERENCES