Metformin for Liver Cancer Prevention in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis
Context: Data on the potential effect of metformin on the risk of liver cancer are limited and inconsistent. Objective: The objective of this study was to review the evidence currently available to examine the potential role of metformin in chemoprevention for liver cancer in patients with type 2 di...
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| Veröffentlicht in: | The journal of clinical endocrinology and metabolism 2012-07, Vol.97 (7), p.2347-2353 |
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| container_title | The journal of clinical endocrinology and metabolism |
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| creator | Zhang, Zhi-Jiang Zheng, Zhi-Jie Shi, Rong Su, Qing Jiang, Qingwu Kip, Kevin E |
| description | Context:
Data on the potential effect of metformin on the risk of liver cancer are limited and inconsistent.
Objective:
The objective of this study was to review the evidence currently available to examine the potential role of metformin in chemoprevention for liver cancer in patients with type 2 diabetes.
Data Sources:
The data sources of the study included the PubMed and SciVerse Scopus databases.
Study Selection:
Selection included studies that assessed the effect of metformin therapy on the risk of liver cancer in patients with type 2 diabetes.
Data Extraction:
Summary effect estimates were derived using a random-effects meta-analysis model.
Data Synthesis:
A database was developed on the basis of five studies consisting of approximately 105,495 patients with type 2 diabetes. In meta-analyses, metformin was associated with an estimated 62% reduction in the risk of liver cancer among patients with type 2 diabetes (odds ratio 0.38, 95% confidence interval 0.24, 0.59; P < 0.001). The effect estimates were heterogeneous across the five included studies (P for heterogeneity = 0.001; I2 = 78%). When restricting the analysis to the four studies related to hepatocellular carcinoma, metformin was again associated with a significantly lower cancer risk (odds ratio 0.30, 95% confidence interval 0.17, 0.52; P < 0.001), and there was evidence of significant heterogeneity between these four studies (P for heterogeneity = 0.03; I2 = 67%).
Conclusions:
Metformin appears to be associated with a lower risk of liver cancer in patients with type 2 diabetes. Further investigation, including mechanistic studies, well-designed cohort studies, and possibly controlled trials, is needed. |
| doi_str_mv | 10.1210/jc.2012-1267 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1024350940</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1024350940</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4481-84c2e72438a6c93e0ce341a449e6744e6e37e1e3f6243e74a9c6c981272f65103</originalsourceid><addsrcrecordid>eNpt0U1vEzEQBmALUdG0cOOMfEHigIu_dr3LLQoUKqWigiJxs1xnVnHYj9TjTZR_j1cJcKkvI8vPjK3XhLwW_EpIwT9s_JXkQjIhS_OMzEStC2ZEbZ6TGedSsNrIX-fkAnHDudC6UC_IuZSFVErpGeluITVD7EJPc6HLsINIF673udxF2EGfwtDTfHznUsg7pPuQ1vT-sAUq6afgHiABfqRz-uOACbqsPP0OuwB76voVzfMdm_euPWDAl-SscS3Cq1O9JD-vP98vvrLlty83i_mSea0rwSrtJRipVeVKXyvgHpQWTusaSqM1lKAMCFBNmQ0Y7WqfXSWkkU1ZCK4uybvj3G0cHkfAZLuAHtrW9TCMaAXPjQWv9UTfH6mPA2KExm5j6Fw8ZGSngO3G2ylgOwWc-ZvT5PGhg9U__DfRDN6egEPv2ibmLAP-d6WQFZcyO310-6FNEPF3O-4h2jW4Nq0tz0uXpmLTzdzkHePTb-Y2dWyDfjX4GHrYRkC0m2GMOWR8-tV_AEmRofU</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1024350940</pqid></control><display><type>article</type><title>Metformin for Liver Cancer Prevention in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Journals@Ovid Ovid Autoload</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>Alma/SFX Local Collection</source><creator>Zhang, Zhi-Jiang ; Zheng, Zhi-Jie ; Shi, Rong ; Su, Qing ; Jiang, Qingwu ; Kip, Kevin E</creator><creatorcontrib>Zhang, Zhi-Jiang ; Zheng, Zhi-Jie ; Shi, Rong ; Su, Qing ; Jiang, Qingwu ; Kip, Kevin E</creatorcontrib><description>Context:
Data on the potential effect of metformin on the risk of liver cancer are limited and inconsistent.
Objective:
The objective of this study was to review the evidence currently available to examine the potential role of metformin in chemoprevention for liver cancer in patients with type 2 diabetes.
Data Sources:
The data sources of the study included the PubMed and SciVerse Scopus databases.
Study Selection:
Selection included studies that assessed the effect of metformin therapy on the risk of liver cancer in patients with type 2 diabetes.
Data Extraction:
Summary effect estimates were derived using a random-effects meta-analysis model.
Data Synthesis:
A database was developed on the basis of five studies consisting of approximately 105,495 patients with type 2 diabetes. In meta-analyses, metformin was associated with an estimated 62% reduction in the risk of liver cancer among patients with type 2 diabetes (odds ratio 0.38, 95% confidence interval 0.24, 0.59; P < 0.001). The effect estimates were heterogeneous across the five included studies (P for heterogeneity = 0.001; I2 = 78%). When restricting the analysis to the four studies related to hepatocellular carcinoma, metformin was again associated with a significantly lower cancer risk (odds ratio 0.30, 95% confidence interval 0.17, 0.52; P < 0.001), and there was evidence of significant heterogeneity between these four studies (P for heterogeneity = 0.03; I2 = 67%).
Conclusions:
Metformin appears to be associated with a lower risk of liver cancer in patients with type 2 diabetes. Further investigation, including mechanistic studies, well-designed cohort studies, and possibly controlled trials, is needed.</description><identifier>ISSN: 0021-972X</identifier><identifier>EISSN: 1945-7197</identifier><identifier>DOI: 10.1210/jc.2012-1267</identifier><identifier>PMID: 22523334</identifier><identifier>CODEN: JCEMAZ</identifier><language>eng</language><publisher>Bethesda, MD: Endocrine Society</publisher><subject>Algorithms ; Biological and medical sciences ; Carcinoma, Hepatocellular - complications ; Carcinoma, Hepatocellular - epidemiology ; Carcinoma, Hepatocellular - prevention & control ; Chemoprevention - methods ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - drug therapy ; Diabetes Mellitus, Type 2 - epidemiology ; Diabetes. Impaired glucose tolerance ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Feeding. Feeding behavior ; Fundamental and applied biological sciences. Psychology ; Humans ; Hypoglycemic Agents - therapeutic use ; Liver Neoplasms - complications ; Liver Neoplasms - epidemiology ; Liver Neoplasms - prevention & control ; Medical sciences ; Metformin - therapeutic use ; Vertebrates: anatomy and physiology, studies on body, several organs or systems ; Vertebrates: endocrinology</subject><ispartof>The journal of clinical endocrinology and metabolism, 2012-07, Vol.97 (7), p.2347-2353</ispartof><rights>Copyright © 2012 by The Endocrine Society</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4481-84c2e72438a6c93e0ce341a449e6744e6e37e1e3f6243e74a9c6c981272f65103</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26128022$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22523334$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhang, Zhi-Jiang</creatorcontrib><creatorcontrib>Zheng, Zhi-Jie</creatorcontrib><creatorcontrib>Shi, Rong</creatorcontrib><creatorcontrib>Su, Qing</creatorcontrib><creatorcontrib>Jiang, Qingwu</creatorcontrib><creatorcontrib>Kip, Kevin E</creatorcontrib><title>Metformin for Liver Cancer Prevention in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis</title><title>The journal of clinical endocrinology and metabolism</title><addtitle>J Clin Endocrinol Metab</addtitle><description>Context:
Data on the potential effect of metformin on the risk of liver cancer are limited and inconsistent.
Objective:
The objective of this study was to review the evidence currently available to examine the potential role of metformin in chemoprevention for liver cancer in patients with type 2 diabetes.
Data Sources:
The data sources of the study included the PubMed and SciVerse Scopus databases.
Study Selection:
Selection included studies that assessed the effect of metformin therapy on the risk of liver cancer in patients with type 2 diabetes.
Data Extraction:
Summary effect estimates were derived using a random-effects meta-analysis model.
Data Synthesis:
A database was developed on the basis of five studies consisting of approximately 105,495 patients with type 2 diabetes. In meta-analyses, metformin was associated with an estimated 62% reduction in the risk of liver cancer among patients with type 2 diabetes (odds ratio 0.38, 95% confidence interval 0.24, 0.59; P < 0.001). The effect estimates were heterogeneous across the five included studies (P for heterogeneity = 0.001; I2 = 78%). When restricting the analysis to the four studies related to hepatocellular carcinoma, metformin was again associated with a significantly lower cancer risk (odds ratio 0.30, 95% confidence interval 0.17, 0.52; P < 0.001), and there was evidence of significant heterogeneity between these four studies (P for heterogeneity = 0.03; I2 = 67%).
Conclusions:
Metformin appears to be associated with a lower risk of liver cancer in patients with type 2 diabetes. Further investigation, including mechanistic studies, well-designed cohort studies, and possibly controlled trials, is needed.</description><subject>Algorithms</subject><subject>Biological and medical sciences</subject><subject>Carcinoma, Hepatocellular - complications</subject><subject>Carcinoma, Hepatocellular - epidemiology</subject><subject>Carcinoma, Hepatocellular - prevention & control</subject><subject>Chemoprevention - methods</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - drug therapy</subject><subject>Diabetes Mellitus, Type 2 - epidemiology</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Etiopathogenesis. Screening. Investigations. Target tissue resistance</subject><subject>Feeding. Feeding behavior</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Humans</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>Liver Neoplasms - complications</subject><subject>Liver Neoplasms - epidemiology</subject><subject>Liver Neoplasms - prevention & control</subject><subject>Medical sciences</subject><subject>Metformin - therapeutic use</subject><subject>Vertebrates: anatomy and physiology, studies on body, several organs or systems</subject><subject>Vertebrates: endocrinology</subject><issn>0021-972X</issn><issn>1945-7197</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpt0U1vEzEQBmALUdG0cOOMfEHigIu_dr3LLQoUKqWigiJxs1xnVnHYj9TjTZR_j1cJcKkvI8vPjK3XhLwW_EpIwT9s_JXkQjIhS_OMzEStC2ZEbZ6TGedSsNrIX-fkAnHDudC6UC_IuZSFVErpGeluITVD7EJPc6HLsINIF673udxF2EGfwtDTfHznUsg7pPuQ1vT-sAUq6afgHiABfqRz-uOACbqsPP0OuwB76voVzfMdm_euPWDAl-SscS3Cq1O9JD-vP98vvrLlty83i_mSea0rwSrtJRipVeVKXyvgHpQWTusaSqM1lKAMCFBNmQ0Y7WqfXSWkkU1ZCK4uybvj3G0cHkfAZLuAHtrW9TCMaAXPjQWv9UTfH6mPA2KExm5j6Fw8ZGSngO3G2ylgOwWc-ZvT5PGhg9U__DfRDN6egEPv2ibmLAP-d6WQFZcyO310-6FNEPF3O-4h2jW4Nq0tz0uXpmLTzdzkHePTb-Y2dWyDfjX4GHrYRkC0m2GMOWR8-tV_AEmRofU</recordid><startdate>201207</startdate><enddate>201207</enddate><creator>Zhang, Zhi-Jiang</creator><creator>Zheng, Zhi-Jie</creator><creator>Shi, Rong</creator><creator>Su, Qing</creator><creator>Jiang, Qingwu</creator><creator>Kip, Kevin E</creator><general>Endocrine Society</general><general>Copyright by The Endocrine Society</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201207</creationdate><title>Metformin for Liver Cancer Prevention in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis</title><author>Zhang, Zhi-Jiang ; Zheng, Zhi-Jie ; Shi, Rong ; Su, Qing ; Jiang, Qingwu ; Kip, Kevin E</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4481-84c2e72438a6c93e0ce341a449e6744e6e37e1e3f6243e74a9c6c981272f65103</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Algorithms</topic><topic>Biological and medical sciences</topic><topic>Carcinoma, Hepatocellular - complications</topic><topic>Carcinoma, Hepatocellular - epidemiology</topic><topic>Carcinoma, Hepatocellular - prevention & control</topic><topic>Chemoprevention - methods</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - drug therapy</topic><topic>Diabetes Mellitus, Type 2 - epidemiology</topic><topic>Diabetes. Impaired glucose tolerance</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Etiopathogenesis. Screening. Investigations. Target tissue resistance</topic><topic>Feeding. Feeding behavior</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Humans</topic><topic>Hypoglycemic Agents - therapeutic use</topic><topic>Liver Neoplasms - complications</topic><topic>Liver Neoplasms - epidemiology</topic><topic>Liver Neoplasms - prevention & control</topic><topic>Medical sciences</topic><topic>Metformin - therapeutic use</topic><topic>Vertebrates: anatomy and physiology, studies on body, several organs or systems</topic><topic>Vertebrates: endocrinology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhang, Zhi-Jiang</creatorcontrib><creatorcontrib>Zheng, Zhi-Jie</creatorcontrib><creatorcontrib>Shi, Rong</creatorcontrib><creatorcontrib>Su, Qing</creatorcontrib><creatorcontrib>Jiang, Qingwu</creatorcontrib><creatorcontrib>Kip, Kevin E</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The journal of clinical endocrinology and metabolism</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhang, Zhi-Jiang</au><au>Zheng, Zhi-Jie</au><au>Shi, Rong</au><au>Su, Qing</au><au>Jiang, Qingwu</au><au>Kip, Kevin E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Metformin for Liver Cancer Prevention in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis</atitle><jtitle>The journal of clinical endocrinology and metabolism</jtitle><addtitle>J Clin Endocrinol Metab</addtitle><date>2012-07</date><risdate>2012</risdate><volume>97</volume><issue>7</issue><spage>2347</spage><epage>2353</epage><pages>2347-2353</pages><issn>0021-972X</issn><eissn>1945-7197</eissn><coden>JCEMAZ</coden><abstract>Context:
Data on the potential effect of metformin on the risk of liver cancer are limited and inconsistent.
Objective:
The objective of this study was to review the evidence currently available to examine the potential role of metformin in chemoprevention for liver cancer in patients with type 2 diabetes.
Data Sources:
The data sources of the study included the PubMed and SciVerse Scopus databases.
Study Selection:
Selection included studies that assessed the effect of metformin therapy on the risk of liver cancer in patients with type 2 diabetes.
Data Extraction:
Summary effect estimates were derived using a random-effects meta-analysis model.
Data Synthesis:
A database was developed on the basis of five studies consisting of approximately 105,495 patients with type 2 diabetes. In meta-analyses, metformin was associated with an estimated 62% reduction in the risk of liver cancer among patients with type 2 diabetes (odds ratio 0.38, 95% confidence interval 0.24, 0.59; P < 0.001). The effect estimates were heterogeneous across the five included studies (P for heterogeneity = 0.001; I2 = 78%). When restricting the analysis to the four studies related to hepatocellular carcinoma, metformin was again associated with a significantly lower cancer risk (odds ratio 0.30, 95% confidence interval 0.17, 0.52; P < 0.001), and there was evidence of significant heterogeneity between these four studies (P for heterogeneity = 0.03; I2 = 67%).
Conclusions:
Metformin appears to be associated with a lower risk of liver cancer in patients with type 2 diabetes. Further investigation, including mechanistic studies, well-designed cohort studies, and possibly controlled trials, is needed.</abstract><cop>Bethesda, MD</cop><pub>Endocrine Society</pub><pmid>22523334</pmid><doi>10.1210/jc.2012-1267</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0021-972X |
| ispartof | The journal of clinical endocrinology and metabolism, 2012-07, Vol.97 (7), p.2347-2353 |
| issn | 0021-972X 1945-7197 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1024350940 |
| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Journals@Ovid Ovid Autoload; Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection |
| subjects | Algorithms Biological and medical sciences Carcinoma, Hepatocellular - complications Carcinoma, Hepatocellular - epidemiology Carcinoma, Hepatocellular - prevention & control Chemoprevention - methods Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - drug therapy Diabetes Mellitus, Type 2 - epidemiology Diabetes. Impaired glucose tolerance Endocrine pancreas. Apud cells (diseases) Endocrinopathies Etiopathogenesis. Screening. Investigations. Target tissue resistance Feeding. Feeding behavior Fundamental and applied biological sciences. Psychology Humans Hypoglycemic Agents - therapeutic use Liver Neoplasms - complications Liver Neoplasms - epidemiology Liver Neoplasms - prevention & control Medical sciences Metformin - therapeutic use Vertebrates: anatomy and physiology, studies on body, several organs or systems Vertebrates: endocrinology |
| title | Metformin for Liver Cancer Prevention in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis |
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