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Statin use and the risk of hepatocellular carcinoma in patients at high risk: A nationwide nested case-control study

Authors
 Gyuri Kim  ;  Suk-Yong Jang  ;  Chung Mo Nam  ;  Eun Seok Kang 
Citation
 Journal of Hepatology, Vol.68(3) : 476-484, 2018 
Journal Title
 Journal of Hepatology 
ISSN
 0168-8278 
Issue Date
2018
Keywords
Cohort study ; Diabetes ; Hepatocellular carcinoma ; Liver cirrhosis ; Statin
Abstract
BACKGROUND & AIMS: Statins are widely used to treat hypercholesterolemia. Statins may prevent hepatocellular carcinoma (HCC), but have not yet been fully studied, particularly in patients at high risk. Therefore, we investigated the risk of HCC after statin use in the whole general population and evaluated the effects of preexisting diabetes mellitus (DM) and liver cirrhosis (LC) on that risk. METHODS: A nationwide, nested case-control study was conducted with data from the National Health Insurance Service Physical Health Examination Cohort 2002-2013 in the Republic of Korea. Individuals diagnosed with HCC were matched to controls based on the time of the follow-up, sex, and age at index date. Odds ratios (ORs) and 95% confidence intervals (CIs) for HCC associated with statin use were analyzed by multivariable conditional logistic regression analyses. In total, 1,642 HCC cases were matched to 8,210 control individuals from 514,866 participants. RESULTS: Statin use was associated with reduced risk of HCC development (adjusted OR [AOR] 0.44; 95% CI 0.33-0.58) compared with nonusers. The reduction in risk was significant in the presence (AOR 0.28; 95% CI 0.17-0.46) and absence of DM (AOR 0.53; 95% CI 0.39-0.73) and in the presence (AOR 0.39; 95% CI 0.26-0.60) and absence of LC (AOR 0.42; 95% CI 0.32-0.57). Statin use also significantly reduced the risk of HCC among patients with DM, without chronic complications (AOR 0.19; 95% CI 0.08-0.46) or with chronic complications (AOR 0.34; 95% CI 0.19-0.64), compared to nonusers. CONCLUSIONS: Statin use may have a beneficial inhibitory effect on HCC development, particularly in patients with DM or LC, at high risk of HCC. LAY SUMMARY: In this longitudinal nationwide population-based nested case-control study, the association between statin use and the risk of HCC was investigated in Asian populations. Herein, we noted a beneficial effect of statin use on the development of HCC in the general population and individuals at high risk of HCC (i.e. those with diabetes or liver cirrhosis).
Full Text
https://www.sciencedirect.com/science/article/pii/S0168827817323978
DOI
10.1016/j.jhep.2017.10.018
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
강은석(Kang, Eun Seok) ORCID logo https://orcid.org/0000-0002-0364-4675
김규리(Kim, Gyuri)
남정모(Nam, Jung Mo) ORCID logo https://orcid.org/0000-0003-0985-0928
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/162031
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