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Risk factors for intrahepatic cholangiocarcinoma: Association between metformin use and reduced cancer risk
Author(s) -
Chaiteerakij Roongruedee,
Yang Ju Dong,
Harmsen William S.,
Slettedahl Seth W.,
Mettler Teresa A.,
Fredericksen Zachary S.,
Kim W. Ray,
Gores Gregory J.,
Roberts Rosebud O.,
Olson Janet E.,
Therneau Terry M.,
Roberts Lewis R.
Publication year - 2013
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.26092
Subject(s) - medicine , metformin , odds ratio , diabetes mellitus , hepatology , gastroenterology , confidence interval , intrahepatic cholangiocarcinoma , obesity , endocrinology , insulin
The associations between diabetes, smoking, obesity, and intrahepatic cholangiocarcinoma (ICC) risk remain inconclusive. Metformin is purportedly associated with a reduced risk for various cancers. This case‐control study evaluated risk factors for ICC and explored the effects of metformin on ICC risk in a clinic/hospital‐based cohort. ICC patients observed at the Mayo Clinic (Rochester, MN) between January 2000 and May 2010 were identified. Age, sex, ethnicity, and residential area‐matched controls were selected from among Mayo Clinic Biobank participants. The associations between potential factors and ICC risk were determined. Six hundred and twelve cases and 594 controls were identified. Factors associated with increased ICC risk included biliary tract diseases (adjusted odds ratio [AOR]: 81.8; 95% confidence interval [CI]: 11.2‐598.8; P < 0.001), cirrhosis (AOR, 8.0; 95% CI: 1.8‐36.5; P = 0.007), diabetes (AOR, 3.6; 95% CI: 2.3‐5.5; P < 0.001), and smoking (AOR, 1.6; 95% CI: 1.3‐2.1; P < 0.001). Compared to diabetic patients not treated with metformin, the odds ratio (OR) for ICC for diabetic patients treated with metformin was significantly decreased (OR, 0.4; 95% CI: 0.2‐0.9; P = 0.04). Obesity and metabolic syndrome were not associated with ICC. Conclusion : This study confirmed diabetes and smoking as independent risk factors for ICC. A novel finding was that treatment with metformin was significantly associated with a 60% reduction in ICC risk in diabetic patients. (H EPATOLOGY 2013)