Li Qiaomei, Xu Hairong, Sui Chengjun, Zhang Hongjuan
Department of Hepatic Surgery, The Third Affiliated Hospital of Naval Medical University, 201805 Shanghai, China.
Second department of biliary tract, The Third Affiliated Hospital of Naval Medical University, 201805 Shanghai, China.
Clin Res Hepatol Gastroenterol. 2022 Feb;46(2):101781. doi: 10.1016/j.clinre.2021.101781. Epub 2021 Jul 29.
The 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.
We 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.
The 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).
In 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.
糖尿病（DM）患者中，关于使用二甲双胍与肝细胞癌（HCC）之间关联的观点存在分歧。因此，我们总结了所有评估二甲双胍治疗与HCC生存及风险关系的已发表研究，并旨在进行一项更新的荟萃分析研究，以更准确地阐明这种关联。
我们在数据库（PubMed和科学网）中搜索了2021年4月之前发表的关于二甲双胍使用对DM患者HCC风险和死亡率影响的文章。我们使用STATA 12.0软件计算比值比（ORs）/相对风险（RRs）或风险比（HRs）及其95%置信区间（CIs），以生成计算效应量和95% CI。
本研究表明，采用随机效应模型时，二甲双胍的使用与DM患者HCC风险降低相关（OR/RR = 0.59，95% CI 0.51 - 0.68，I² = 96.5%，p < 0.001）。此外，该研究表明，采用随机效应模型时，二甲双胍的使用与DM患者HCC全因死亡率降低相关（HR = 0.74，95% CI 0.66 - 0.83，I² = 49.6%，p = 0.037）。
总之，我们的研究支持DM患者使用二甲双胍与HCC风险和全因死亡率降低显著相关。需要更多关注二甲双胍治疗作为HCC保护因素的前瞻性研究来验证这些发现的准确性。
