The effect of prediabetes on hepatocellular carcinoma risk: a systematic review and meta-analysis

INTRODUCTION: Some studies suggested an increased risk of hepatocellular carcinoma (HCC) risk in subjects with prediabetes, whereas other studies have reported negative results. Therefore, we did this meta-analysis to assess the role of prediabetes on HCC risk. EVIDENCE ACQUISITION: We searched studies from PubMed, Embase, and Web of Science databases. The strength of association between prediabetes and HCC risk was assessed by calculating hazard ratio (HR) with 95% CI. EVIDENCE SYNTHESIS: A total of 8 cohort studies and 1 case-control study with 1384594 individuals were included. Patients with prediabetes showed an increased HCC risk (HR= 1.21; 95% CI, 1.13-1.30; P<0.00001). Subgroup analyses were performed according to race and gender. The results showed that both Asians with prediabetes (HR= 1.19; 95% CI, 1.11-1.28; P<0.00001) and Caucasians with prediabetes (HR=2.12; 95% CI, 1.36-3.31; P=0.001 were significantly associated with increased risk of HCC, respectively. In the subgroup analysis by gender, both male patients with prediabetes (HR= 1.49; 95% CI, 1.03-2.15; P=0.03) and female patients with prediabetes (HR= 1.24; 95% CI, 1.01-1.52; P=0.04) showed increased risk of HCC, respectively. CONCLUSIONS: In conclusion, this meta-analysis demonstrated that prediabetes might be a risk factor of HCC.