糖尿病患同時罹患B型或C型肝炎患者服用Statin藥物是否可以降低肝癌罹患風險？

Is it possible for diabetics infected with HBV or HCV to reduce the risk of hepatocellular carcinoma by taking a Statin?

邱桂芬(Guei-Fen Chiu) ； 張郁函(Yu-Han Chang) ； 林昆德(Kun-Der Lin)

《台灣公共衛生雜誌》 36卷3期 (2017/06) Pp. 301-313

https://doi.org/10.6288/TJPH201736105113

摘要

目標：探討Statin劑量效應與罹患肝癌之相關性。方法：本篇研究為病例對照研究，利用國衛院2010年承保抽樣檔納入50歲以上2005-2010年糖尿病之群體（ICD-9 code: 250.x）至少使用OAD或insulin三個月以上之個案往前回溯Statin暴露量。病例組為糖尿病且被確診肝癌個案（ICD-9: 155），對照組為糖尿病並未診斷肝癌之個案。結果：HBV（累積劑量＞298 DDDs:OR=0.41; 95% CI: 0.24-0.72）或HCV（累積劑量＞205 DDDs: OR=0.25; 95% CI: 0.13-0.48）糖尿病患者若服用Statin累積劑量越高與降低肝癌之風險呈現劑量效應關係（p＜0.001）。結論：HBV、HBC之糖尿病個案先前合併使用糖尿病藥物與Statin與降低肝癌之風險呈現劑量效應相關。

關鍵字

肝癌 ； 糖尿病 ； Statin

並列摘要

Objectives: To determine the relationship between the dose effect of Statin and the risk of HCC. Methods: This study was a case-control study. All participants were ＞ 50 years of age and were diagnosed with diabetes (ICD-9: 250.x0, 205.x2) and were treated with an anti-diabetic agent for at least for 3 months according to the NHID, LHID 2010 (Longitudinal Health Insurance database 2010). We captured the use of a Statin before the index date in patients with type II diabetes. Patients diagnosed with a hepatoma (ICD-9:155) were defined as the case group. Results: The risk of hepatoma was reduced in patients with higher cumulative DDDs Statin use compared to Statin non-users (HBV population: cumulative dose＞ 298 DDDs [OR=0.41, 95% CI: 0.24-0.72]; HCV population: cumulative dose ＞ 205 DDDs [OR= 0.25; 95% CI: 0.13-0.48]). Conclusions: A dose-response relationship exists between lower risk for hepatoma and higher cumulative DDDs of Statin use.

並列關鍵字

hepatocellular carcinoma ； diabetes mellitus ； Statin

參考文獻

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