Chinese herbal medicine decreases incidence of hepatocellular carcinoma in diabetes mellitus patients with regular insulin management

doi:10.4251/wjgo.v16.i3.716

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World Journal of Gastrointestinal Oncology

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastrointest Oncol. Mar 15, 2024; 16(3): 716-731
Published online Mar 15, 2024. doi: 10.4251/wjgo.v16.i3.716

Chinese herbal medicine decreases incidence of hepatocellular carcinoma in diabetes mellitus patients with regular insulin management

Hsiang-Chun Lai, Ju-Chien Cheng, Hei-Tung Yip, Long-Bin Jeng, Sheng-Teng Huang

Hsiang-Chun Lai, Graduate Institute of Chinese Medicine, School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 404328, Taiwan

Ju-Chien Cheng, Department of Medical Laboratory Science and Biotechnology, China Medical University, Taichung 404, Taiwan

Hei-Tung Yip, Management Office for Health Data, China Medical University Hospital, Taichung 404327, Taiwan

Long-Bin Jeng, Organ Transplantation Center, China Medical University Hospital, Taichung 40447, Taiwan

Sheng-Teng Huang, Department of Chinese Medicine, China Medical University Hospital; School of Chinese Medicine, China Medical University, Taichung 40447, Taiwan

Author contributions: Lai HC contributed to conceptualization, methodology, writing - original draft; Cheng JC contributed to resources, investigation, validation, editing; Yip HT contributed to software, formal analysis, visualization; Jeng LB contributed to resources, supervision, editing; Huang ST contributed to methodology, writing-reviewing and editing, project administration, funding acquisition.

Supported by the National Science and Technology Council of Taiwan, No. NSC112-2320-B-039-045-; China Medical University Hospital, No. DMR-111-013, No. DMR-111-195, No. DMR-112-004 and No. DMR-112-177; and Department of Chinese Medicine and Pharmacy and Ministry of Health and Welfare, No. MOHW-112-CMC-03.

Institutional review board statement: This study was approved by the Institutional Review Board of China Medical University Hospital Research Ethics Committee, No. CMUH109-REC2-031 (CR-3).

Informed consent statement: In the study, all available data were extracted from NHIRD. All records and personal information were anonymized prior to analysis, thus the requirement for written informed consent was waived.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Data sharing statement: The datasets generated for this study are available upon request by the corresponding authors at sheng.teng@yahoo.com.

STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.

Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Sheng-Teng Huang, MD, PhD, Doctor, Professor, Department of Chinese Medicine, China Medical University Hospital; School of Chinese Medicine, China Medical University, No. 2 Yude Road, North District, Taichung 40447, Taiwan. sheng.teng@yahoo.com

Received: October 10, 2023
Peer-review started: October 10, 2023
First decision: December 6, 2023
Revised: December 31, 2023
Accepted: February 1, 2024
Article in press: February 1, 2024
Published online: March 15, 2024
Processing time: 153 Days and 18.1 Hours

Core Tip

Core Tip: Type 2 diabetes mellitus (DM) is an independent risk factor for hepatocellular carcinoma (HCC), while insulin is a potent mitogen. In this propensity-score-matched population-based cohort study, we investigated whether regular herbal medicine use can decrease HCC risk in DM patients with regular insulin control. DM patients with regular herb use had a 12% decreased risk of HCC compared to the control group. The cohort with herb use of > 5 years cumulatively exhibited a protective effect against development of HCC. Moreover, among patients who developed HCC, herb users exhibited a longer survival time than non-users (adjusted hazard ratio = 0.78).