Type 2 diabetes and gender differences in liver cancer by considering different confounding factors: a meta-analysis of cohort studies

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• 作者：Yuqin Wang ; MD^a ; ¹ ; Baochan Wang ; MD^a ; ¹ ; Shiyan Yan ; MD^a ; Feng Shen ; MD^a ; Haixia Cao ; MD^a ; Jiangao Fan ; MD^a ; Rongrong Zhang ; MD^b ; ^{zhangrr_dr@126.com" class="auth_mail" title="E-mail the corresponding author} ; Jun Gu ; MD^c ; ^{Jung0011@126.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Type 2 diabetes ; Liver cancer ; Meta-analysis ; Cohort study
• 刊名：Annals of Epidemiology
• 出版年：2016
• 出版时间：November 2016
• 年：2016
• 卷：26
• 期：11
• 页码：764-772
• 全文大小：1309 K

文摘

Questions remain uncertainty regarding the gender differences in the relationship between type 2 diabetes (T2DM) and liver cancer risk. By considering several confounding factors, we aimed to identify this issue according to a meta-analysis of cohort studies.

Methods

We searched EMBASE and MEDLINE for studies on the association between T2DM and risk of liver cancer up to November 30, 2014. A random-effects model was performed to calculate summary relative risks (SRRs) with corresponding 95% confidence intervals (CIs).

Results

A total of 24 cohort studies (including more than 20,000 liver cancer cases) were recruited. T2DM was associated with an elevated liver cancer incidence in both men (SRR = 2.16; 95% CI, 1.74–2.69) and women (SRR = 1.85; 95% CI, 1.40–2.44). Stratified analyses showed that the risk associations were significantly stronger in non-Asian than those in Asian for both men and women. Both tobacco smoking and body mass index were significant confounding factors for the T2DM-liver cancer association in men, whereas alcohol use was not the case. The SRR estimates of liver cancer mortality with T2DM were statistically significant in both men and women (men: SRR = 2.26; 95% CI, 1.60–3.19 and women: SRR = 2.01; 95% CI, 1.45–2.74).

Conclusions

Results of this meta-analysis indicate that the T2DM-liver cancer correlation is confounded by smoking and body mass index in both men and women. Results also suggest a significantly stronger T2DM-liver cancer correlation in non-Asian than that in Asian for both men and women.