Alcohol and HCV Chronic Infection Are Risk Cofactors of Type 2 Diabetes Mellitus for Hepatocellular Carcinoma in Italy

Balbi, Massimiliano; Donadon, Valter; Ghersetti, Michela; Grazioli, Silvia; Valentina, Giovanni Della; R, Gardenal; Mas, Maria Dal; Casarin, Pietro; Zanette, Giorgio; Miranda, Cesare; Cimarosti, Paolo

doi:10.3390/ijerph7041366

Cited by 21 publications

(16 citation statements)

References 37 publications

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“…5) Ethanol inhibits the effects of the interferon alpha antiviral response (13,39). 6) Alcohol increases hepatic iron stores, and iron overload is associated with HCV disease progression (40)(41)(42).…”

Section: Resultsmentioning

confidence: 99%

New Insights Into the Relationships Among Alcohol Consumption, Hepatocellular Carcinoma and Hepatitis C Virus Infection

Ghannad¹,

Mohammadi²,

Kazemian³

2014

Avicenna J Clin Microbiol Infect

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Context: Viral hepatitis and the consumption of alcohol are recognized as important reasons for the development of liver disease throughout the world. It would also seem that chronic alcoholism causes more severe and rapid progression of liver disease in patients with chronic hepatitis C, leading to more frequent liver cirrhosis and hepatocellular carcinoma. Evidence Acquisition: The data for this article were obtained through an initial Medline search and from the references of relevant articles, and used to provide updated information on the relationship between alcohol consumption and the hepatitis C virus. Results: Excessive alcohol consumption among patients with chronic hepatitis C is likely to result in more severe hepatic injuries, promote pathologic progression to cirrhosis, and increase the risk of developing hepatocellular carcinoma. Although the exact mechanisms involved in the progression of chronic hepatitis C in alcoholic patients have not been definitely established, possible alcohol-induced enhancement of viral replication, iron overload, immunologic suppression, the role of NF-kappa B, and the signaling pathways involved in its activation, have been suggested. Significant correlations have been reported between hepatitis C virus RNA levels and the amount of alcohol consumed by an individual. Interferon therapy is less effective for alcohol patients, than non-alcoholic patients, even after a period of abstinence. The obtained data suggest that a hepatitis C virus infection is an important cofactor in the pathogenesis of liver disease among patients with an alcohol problem. Conclusions: In light of a possible synergistic effect between alcohol and hepatitis C virus replication, total abstention ought to be recommended, and due to alcohol's inhibitory effect on interferon therapy, patients with alcohol problems should not be treated until they stop drinking.Keywords:Hepatitis C; Carcinoma, Hepatocellular; Alcohols; Interferons Implication for health policy/practice/research/medical education: Chronic alcoholism in patients with chronic hepatitis C appears to cause more severe and rapidly progressive liver disease, leading more frequently to liver cirrhosis and HCC. In conclusion, patients with chronic hepatitis C should limit their alcohol intake and if cirrhosis is present or interferon therapy is planned, complete avoidance from alcohol should be encouraged.

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Section: Resultsmentioning

confidence: 99%

New Insights Into the Relationships Among Alcohol Consumption, Hepatocellular Carcinoma and Hepatitis C Virus Infection

Ghannad¹,

Mohammadi²,

Kazemian³

2014

Avicenna J Clin Microbiol Infect

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“…The hepatocellular carcinoma (HCC) incidence is higher in those with T2DM in the two genders, with a greater risk in males and in those with concomitant hepatitis C virus (HCV) infection: As the majority of epidemiological studies indicate a 2-3-fold increase in liver cancer in diabetic patients, it is feasible that diabetes may also act synergistically with other well-established risk factors for HCC, including hepatitis B virus and HCV infection, non-alcoholic fatty liver disease (also considered as hepatic manifestation of diabetes and metabolic syndrome), non-alcoholic steatohepatitis and chronic alcohol consumption leading to steatosis and cirrhosis (1,3,16). In particular, the mitogenic pathway of insulin is unlikely to be involved considering that healthy liver cells, due to insulin secretion bursts in the portal circulatory system, are physiologically exposed to higher insulin concentrations compared to other peripheral tissues (10), above all in the insulin-resistant hyperinsulinemic type 2 states (whereas in insulin-deficient T1DM individuals treated with exogenous insulin, the liver is exposed to the same insulin levels as the other organs).…”

Section: Incidence Of Different Types Of Cancer Among Diabetic Patientsmentioning

confidence: 99%

Diabetes and cancer: A critical appraisal of the pathogenetic and therapeutic links

Gristina¹,

Cupri²,

Torchio³

et al. 2014

Biomedical Reports

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Abstract. Diabetes and cancer represent two common, multifactorial, chronic and potentially fatal diseases, not infrequently co-diagnosed in the same patient. Epidemiological data demonstrate significant increases of the cancer incidence in patients with obesity and diabetes, which is more evident for certain site-specific cancers. Although there is increasing evidence that strongly indicates an augmented risk of cancer in diabetic patients, several confounding factors complicate the ability to precisely assess the risk. Mainly in insulin-resistant states (such as in type 2 diabetes mellitus and in metabolic syndrome), direct associations between obesity-related hyperinsulinemia and increasing circulating insulin-like growth factor-1 (IGF-1) levels have been implicated as key factors in the mechanisms involved in carcinogenesis. Whilst anti-diabetic drugs can increase the cancer risk, anti-proliferative drugs may cause diabetes or aggravate pre-existing diabetes. Additionally, an increasing number of targeted anti-cancer therapies may interfere with the pathways shared by IGF-1 and insulin receptors, showing a adverse effect on glucose metabolism through various mechanisms. Although there is a requirement for large-scale randomized evidence, the present review summarizes the majority of the epidemiological association studies between diabetes and various types of cancer, discussing the pathophysiological mechanisms that may be involved in promoting carcinogenesis in diabetes and the potential impact of different anti-diabetic therapies on cancer risk.

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“…The oxidative stress associated with heavy alcohol consumption increases risk and contributes to the onset and progression of coronary heart disease, stroke and diabetes mellitus (Rehm et al ., ; Balbi et al ., ). However, low volumes of alcohol consumption may have a protective mechanism against such diseases (Rehm et al ., ).…”

Section: Introductionmentioning

confidence: 97%

Dietary adequacy and alcohol consumption of Inuvialuit women of child‐bearing age in the Northwest Territories, Canada

Kolahdooz

Spearing

Corriveau

et al. 2013

J Human Nutrition Diet

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Alcohol and HCV Chronic Infection Are Risk Cofactors of Type 2 Diabetes Mellitus for Hepatocellular Carcinoma in Italy

Cited by 21 publications

References 37 publications

New Insights Into the Relationships Among Alcohol Consumption, Hepatocellular Carcinoma and Hepatitis C Virus Infection

New Insights Into the Relationships Among Alcohol Consumption, Hepatocellular Carcinoma and Hepatitis C Virus Infection

Diabetes and cancer: A critical appraisal of the pathogenetic and therapeutic links

Dietary adequacy and alcohol consumption of Inuvialuit women of child‐bearing age in the Northwest Territories, Canada

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