Hatia Rikita I, Hwang Lu-Yu, Li Ruosha, Troisi Catherine, Jalal Prasun K, Amos Christopher I, Gomez Henry F, Chun Yun Shin, Rashid Asif, Kaseb Ahmed O, Scheet Paul A, Hassan Manal M
Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Department of Epidemiology, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA.
J Hepatocell Carcinoma. 2025 Jan 21;12:93-106. doi: 10.2147/JHC.S477141. eCollection 2025.
Hepatocellular carcinoma (HCC) disproportionately affects Hispanic persons with higher age-specific incidence and increased mortality rates compared to non-Hispanic Whites. These high rates of incidence and mortality may be explained by the variation in risk factors. Given the high prevalence of type 2 diabetes mellitus (DM) among the Hispanic population, we aimed to assess the risk and prognosis of HCC in Mexican Americans with type 2 DM with consideration of treatment for DM.
A case-control study of 241 Mexican American HCC patients and 500 healthy controls in Texas was conducted. Multivariable logistic regression analysis was performed to determine the association between type 2 DM and HCC risk while adjusting for other risk factors. Also, a restricted analysis of patients with type 2 DM was conducted to determine the effects of age at onset and duration of DM on HCC risk. Interactions among DM, heavy alcohol consumption, and viral hepatitis infection were examined. Overall survival was examined, and multivariable Cox proportional hazards regression analysis was performed for HCC patients with type 2 DM.
The adjusted odds ratio (AOR) for DM was 2.74 (P < 0.01). Compared with patients who had DM for 2-10 years, those who had it for at least 20 years had an AOR of 4.60 ( = 0.04). Metformin use was associated with a reduced risk of death in HCC cases with type 2 DM, with a hazard ratio of 0.72 ( = 0.01) as compared with non-users.
Our results demonstrate that type 2 DM was independently associated with increased risk of HCC among Mexican Americans. Metformin use was associated with improved survival among HCC patients with type 2 DM. Type 2 DM significantly increased the risk of HCC alone and in conjunction with other parameters of metabolic syndrome in the Mexican American population after adjusting for other risk factors.
肝细胞癌（HCC）对西班牙裔人群的影响尤为严重，与非西班牙裔白人相比，其特定年龄发病率更高，死亡率也更高。这些高发病率和死亡率可能由风险因素的差异来解释。鉴于2型糖尿病（DM）在西班牙裔人群中普遍存在，我们旨在评估2型糖尿病的墨西哥裔美国人患HCC的风险和预后，并考虑糖尿病的治疗情况。
在德克萨斯州对241例墨西哥裔美国HCC患者和500名健康对照者进行了病例对照研究。进行多变量逻辑回归分析，以确定2型糖尿病与HCC风险之间的关联，同时对其他风险因素进行调整。此外，对2型糖尿病患者进行了受限分析，以确定糖尿病发病年龄和病程对HCC风险的影响。研究了糖尿病、大量饮酒和病毒肝炎感染之间的相互作用。对总体生存率进行了检查，并对2型糖尿病的HCC患者进行了多变量Cox比例风险回归分析。
糖尿病的调整优势比（AOR）为2.74（P < 0.01）。与患糖尿病2至10年的患者相比，患糖尿病至少20年的患者的AOR为4.60（ = 0.04）。在2型糖尿病的HCC病例中，使用二甲双胍与死亡风险降低相关，与未使用者相比，风险比为0.72（ = 0.01）。
我们的结果表明，2型糖尿病与墨西哥裔美国人患HCC的风险增加独立相关。使用二甲双胍与2型糖尿病的HCC患者生存率提高相关。在调整其他风险因素后，2型糖尿病在墨西哥裔美国人群中单独以及与代谢综合征的其他参数共同作用时，均显著增加了患HCC的风险。
