Obesity and Diabetes Mellitus As Risk Factors for Hepatocellular Carcinoma

Abstract

Primary liver cancer is the fifth most common malignancy world wide, accounting for 5.6% of all human cancers and the third leading cause of cancer-related death, exceeded only by cancers of the lung and stomach. The burden of (HCC) has been increasing in Egypt with a doubling in the incidence rate in the past 10 years. The prevalence of overweight and obesity is increasing rapidly worldwide, especially in developing countries. Overall, there is considerable evidence that overweight and obesity are associated with risk for some of the most common cancers including HCC. The most common type of diabetes mellitus (type II) seems to be associated with liver and pancreatic cancer and probably with colorectal cancer. The strategy of Chemotherapy Treatment in diabetic cancerous patients varies according to associated co-morbidity such as renal insufficiency, cardiovascular diseases and diabetic neuropathy. The aim of this Essay is to study the impact of obesity and diabetes mellitus on the development of HCC. In multiple logistic regression analyses, diabetes increased the risk for HCC three fold and there is a synergistic effect about 37-fold increase in HCC incidence due to the combined presence of diabetes and HCV (Hepatitis C Virus). The risk of HCC in patients with chronic hepatitis C increases in proportion to BMI in a wide range of its values, from underweight to obese. Many studies have found an increased risk about 1.5 to 4 folds of HCC among obese individuals. A number of possible mechanisms might explain the association between obesity, diabetes mellitus and HCC. Obesity is associated with insulin resistance and elevated insulin like growth factor, which is a mitogen that stimulates cell growth. Most case subjects with diabetes are non insulin dependent and are characterized by insulin resistance, and Hyp