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Metformin and risk of hepatocellular carcinoma: are statins the missing link?
  1. Siddharth Singh1,
  2. Preet Paul Singh2
  1. 1Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
  2. 2Department of Medical Oncology, Mayo Clinic, Rochester, Minnesota, USA
  1. Correspondence to
    Dr Siddharth Singh, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA; singh.siddharth2{at}mayo.edu

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We read with great interest, the recent article titled ‘Metformin decreases hepatocellular carcinoma risk in a dose-dependent manner: population-based and in vitro studies’ by Chen and colleagues published online in July in the Journal.1 In this large, population-based, case-control study using the Taiwanese National Health Insurance Research Database, they reported that in patients with diabetes mellitus (DM), metformin use is associated with a decrease in the risk of hepatocellular cancer (HCC) in a dose- and duration-dependent manner. Metformin users had a 21% lower risk of HCC on multivariate stratified analysis, after adjusting for potential confounders (age, gender, hepatitis B, hepatitis C, liver cirrhosis, DM duration and antidiabetic …

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