Meta-analysis of studies using metformin as a reducer for liver cancer risk in diabetic patients. Issue 19 (May 2017)

• Record Type: Journal Article
• Authors: Ma, Shujuan; Zheng, Yixiang; Xiao, Yanni; Zhou, Pengcheng; Tan, Hongzhuan
• Other Names: Kapritsou. Maria section editor.
• Is Part Of: Medicine. Volume 96:Issue 19(2017)
• Publication Date: 2017-05
• Subjects: diabetes mellitus -- liver cancer -- meta-analysis -- metformin; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000006888
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract : Abstract: Metformin has garnered more interest as a chemo-preventive agent given the increased liver cancer risk in diabetic patients. This work was undertaken to better understand the effect of metformin use on liver cancer risk in diabetic patients. A comprehensive literature search was performed in PubMed, Embase, BIOSIS Previews, Web of Science, and Cochrane Library through July 30, 2016. Meta-analyses were performed using Stata version 12.0, with odds ratio (ORs) and 95% confidence intervals (CIs) as effect measures. Twenty-three studies were included. Meta-analysis of 19 studies involving 550, 882 diabetic subjects suggested that metformin use reduced the ratio of liver cancer by 48% (OR = 0.52; 95% CI, 0.40–0.68) compared with nonusers. The protective effect was validated in all the exploratory subgroup analyses, except that pooled result of post hoc analyses of 2 randomized controlled trials found no significant difference between subjects with metformin and those without, with OR being 0.84 (95% CI, 0.10–6.83). After adjusting for hepatitis B/C virus infection, cirrhosis, obesity, behavioral factors, and time-related bias, the association was stable, pooled OR ranged from 0.42 to 0.75. A protective effect for liver cancer was found in diabetic metformin users. However, more randomized clinical evidence is still needed to verify the results.