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J Clin Endocrinol Metab. 2012 Jul;97(7):2347-53. doi: 10.1210/jc.2012-1267. Epub 2012 Apr 20.

Metformin for liver cancer prevention in patients with type 2 diabetes: a systematic review and meta-analysis.

Author information

1
Department of Epidemiology, School of Public Health, Shanghai Jiao Tong University, 227 South Chongqing Road, Shanghai 200025, China. zhang.zj@msn.com

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; I(2) = 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; I(2) = 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.

PMID:
22523334
DOI:
10.1210/jc.2012-1267
[Indexed for MEDLINE]

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