Type 2 diabetes and gender differences in liver cancer by considering different confounding factors: a meta-analysis of cohort studies
A partir d'une revue systématique de la littérature publiée jusqu'en novembre 2014 (24 études de cohorte, plus de 20 000 cas), cette méta-analyse évalue l'association entre un diabète de type 2 et le risque de cancer du foie, en prenant en compte divers facteurs (sexe, tabagisme, consommation d'alcool, indice de masse corporelle, origine ethnique), ou la mortalité spécifique
Background : 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, while 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; 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 BMI 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.