Tuunanen Iida, Hautakoski Ari, Huhtamäki Heikki, Arffman Martti, Sund Reijo, Puistola Ulla, Karihtala Peeter, Jukkola Arja, Urpilainen Elina
Department of Obstetrics and Gynecology, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, University of Oulu, 90220 Oulu, Finland.
Research Unit of Clinical Medicine, University of Oulu, 90220 Oulu, Finland.
Biomedicines. 2024 Jul 24;12(8):1654. doi: 10.3390/biomedicines12081654.
This study aimed to explore whether the prediagnostic use of metformin and statins is associated with the prognosis of patients with hepatocellular carcinoma (HCC) and type 2 diabetes. We identified 1383 eligible individuals who had both type 2 diabetes and HCC diagnosed between 1998 and 2017 from several Finnish registers. Cox models were fitted for cause-specific and all-cause mortality in relation to the use of antidiabetic medications and statins prior to the HCC diagnosis. Prediagnostic metformin use was associated with decreased overall mortality (hazard ratio 0.84, 95% confidence interval 0.74-0.94) compared with nonuse in patients with type 2 diabetes. Similarly, slightly decreased HCC mortality and other-cause mortality were observed among metformin users. The results were inconclusive regarding metformin use and both overall and HCC mortality among patients with localized HCC. No discernible contrast between statin users and nonusers was found in overall mortality nor HCC mortality in either the whole cohort or patients with localized cancer.
本研究旨在探讨二甲双胍和他汀类药物的诊断前使用是否与肝细胞癌（HCC）合并2型糖尿病患者的预后相关。我们从芬兰的几个登记处识别出1383名在1998年至2017年间被诊断为同时患有2型糖尿病和HCC的符合条件的个体。针对HCC诊断前使用抗糖尿病药物和他汀类药物的情况，采用Cox模型对特定病因死亡率和全因死亡率进行拟合。与2型糖尿病患者中未使用二甲双胍的患者相比，诊断前使用二甲双胍与总体死亡率降低相关（风险比0.84，95%置信区间0.74 - 0.94）。同样，在使用二甲双胍的患者中观察到HCC死亡率和其他原因死亡率略有下降。关于局限性HCC患者使用二甲双胍与总体死亡率和HCC死亡率的关系，结果尚无定论。在整个队列或局限性癌症患者中，他汀类药物使用者和非使用者在总体死亡率或HCC死亡率方面均未发现明显差异。
