Type 2 diabetes doubles hepatic carcinoma risk

PATIENTS with type 2 diabetes are at increased risk of developing hepatic carcinoma, according to new research which underlines the importance of monitoring liver function in patients with diabetes.

In the retrospective case-controlled study Italian researchers looked at the association between type 2 diabetes and hepatocellular carcinoma (HCC) in 465 HCC patients, 618 patients with liver cirrhosis and 490 controls matched for diabetes history.

They found that patients with type 2 diabetes had double the risk of HCC, independent of age, gender, BMI, alcohol abuse and hepatitis B and C status.

Around 85% of patients were diagnosed with type 2 diabetes at least six months before the onset of HCC.

Patients with type 2 diabetes had a significantly increased risk of liver disease and death from liver cirrhosis, the research found.

The findings were consistent with a postulated underlying relationship between diabetes mellitus and cancer, the authors said, and this link might be related to insulin resistance and consequent hyperinsulinaemia.

Professor Don Chisholm, an endocrinologist from the Garvan Institute of Medical Research and St Vincent’s Hospital, Sydney, said the data showed a real connection between type 2 diabetes and HCC, but he questioned the proposed mechanism.

“It may be more to do with fatty liver than insulin levels, but that needs to be resolved,” he said.

Professor Chisholm recommended regular liver function tests and palpation of the liver in patients with type 2 diabetes.

World J Gastroenterol 2009; 15:2506-11