• Hsin-Hung Chen, Ming-Chia Lin, Chih-Hsin Muo, Su-Yin Yeh, Fung-Chang Sung, and Chia-Hung Kao.
• From the School of Medicine and Public Health, Chung Shan Medical University, Taichung, Taiwan (H-HC); Division of Metabolism and Endocrinology, Changhua Christian Hospital, Changhua, Taiwan (H-HC); Division of Metabolism and Endocrinology, Nantou Christian Hospital, Nantou, Taiwan (H-HC); Department of Nuclear Medicine, E-DA Hospital, Kaohsiung, Taiwan (M-CL); Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan (C-HM, F-CS); Asia University, Taichung, Taiwan (S-YY); Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine, Taichung, Taiwan (F-CS, C-HK); and Department of Nuclear Medicine and PET Center China Medical University Hospital, Taichung, Taiwan (C-HK).
• Medicine (Baltimore). 2015 Jun 1; 94 (24): e1013.

AbstractPrevious studies have shown that metformin or statins may decrease hepatocellular carcinoma (HCC) in diabetic patients. Accordingly, this article evaluates whether combination therapy may further reduce HCC. Newly diagnosed type 2 diabetes mellitus (DM) patients, excluding those with history of malignancy prior to the date of DM diagnosis, were recruited to a DM cohort. DM patients developed HCC as the cancer cohort and the date for HCC diagnosis as index date. Non-cancer cohort was frequency matched with 4:1 according to age, sex, DM-year, and index date as case group from DM cohort. Patients who were treated with statins showed a 63% decreased risk of HCC (odds ratio [OR] = 0.37; 95% confidence interval [CI] = 0.27-0.49). Patients who consumed simvastatin, atorvastatin, or rosuvastatin significantly decreased risk for HCC (OR = 0.32, 0.31, and 0.22; 95% CI = 0.18-0.58, 0.19-0.52, and 0.08-0.61, respectively). Metformin combinations with simvastatin, atorvastatin, or rosuvastatin may decrease HCC (OR = 0.30, 0.30, and 0.24; 95% CI = 0.15-0.59, 0.16-0.54, and 0.08-0.70, respectively). The comorbidities for HCC were decreased by consuming simvastatin and atorvastatin (OR = 0.31 and 0.29; 95% CI = 0.14-0.67 and 0.15-0.57, respectively). Only combination therapy of metformin and simvastatin may significantly decreased HCC comorbidities (OR = 0.26; 95% CI = 0.11-0.60) in our study. In Asia, not all metformin combinations with statins may reduce the incidence of HCC and not all of this kind of combination therapy may decrease the HCC comorbidities.

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