BACKGROUND & AIMS Statins are widely used to treat hypercholesterolemia. Statins may prevent hepatocellular carcinoma (HCC), but have not yet been fully studied, particularly in patients at high risk. Therefore, we investigated the risk of HCC after statin use in the whole general population and evaluated the effects of preexisting diabetes mellitus (DM) and liver cirrhosis (LC) on that risk. METHODS A nationwide, nested case-control study was conducted with data from the National Health Insurance Service Physical Health Examination Cohort 2002-2013 in the Republic of Korea. Individuals diagnosed with HCC were matched to controls based on the time of the follow-up, sex, and age at index date. Odds ratios (ORs) and 95% confidence intervals (CIs) for HCC associated with statin use were analyzed by multivariable conditional logistic regression analyses. In total, 1,642 HCC cases were matched to 8,210 control individuals from 514,866 participants. RESULTS Statin use was associated with reduced risk of HCC development (adjusted OR [AOR] 0.44; 95% CI 0.33-0.58) compared with nonusers. The reduction in risk was significant in the presence (AOR 0.28; 95% CI 0.17-0.46) and absence of DM (AOR 0.53; 95% CI 0.39-0.73) and in the presence (AOR 0.39; 95% CI 0.26-0.60) and absence of LC (AOR 0.42; 95% CI 0.32-0.57). Statin use also significantly reduced the risk of HCC among patients with DM, without chronic complications (AOR 0.19; 95% CI 0.08-0.46) or with chronic complications (AOR 0.34; 95% CI 0.19-0.64), compared to nonusers. CONCLUSIONS Statin use may have a beneficial inhibitory effect on HCC development, particularly in patients with DM or LC, at high risk of HCC. LAY SUMMARY In this longitudinal nationwide population-based nested case-control study, the association between statin use and the risk of HCC was investigated in Asian populations. Herein, we noted a beneficial effect of statin use on the development of HCC in the general population and individuals at high risk of HCC (i.e. those with diabetes or liver cirrhosis).

中文翻译：

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高危患者中他汀类药物的使用和肝细胞癌的风险：一项全国性的巢式病例对照研究

背景和目的 他汀类药物广泛用于治疗高胆固醇血症。他汀类药物可以预防肝细胞癌 (HCC)，但尚未得到充分研究，尤其是在高危患者中。因此，我们调查了在整个普通人群中使用他汀类药物后发生 HCC 的风险，并评估了先前存在的糖尿病 (DM) 和肝硬化 (LC) 对该风险的影响。方法 使用来自大韩民国 2002-2013 年国家健康保险服务体检队列的数据进行了一项全国性的巢式病例对照研究。根据随访时间、性别和索引日期的年龄，将诊断为 HCC 的个体与对照组相匹配。通过多变量条件逻辑回归分析分析了与他汀类药物使用相关的 HCC 的优势比 (OR) 和 95% 置信区间 (CI)。总共有 1,642 例 HCC 病例与来自 514,866 名参与者的 8,210 名对照个体相匹配。结果 与未使用他汀类药物的人相比，使用他汀类药物与 HCC 发展风险降低相关（调整后的 OR [AOR] 0.44；95% CI 0.33-0.58）。存在 (AOR 0.28; 95% CI 0.17-0.46) 和不存在 DM (AOR 0.53; 95% CI 0.39-0.73) 和存在 (AOR 0.39; 95% CI 0.26-0.60) 时风险降低显着和不存在 LC（AOR 0.42；95% CI 0.32-0.57）。与未使用他汀类药物的患者相比，他汀类药物的使用还显着降低了无慢性并发症（AOR 0.19；95% CI 0.08-0.46）或有慢性并发症（AOR 0.34；95% CI 0.19-0.64）的 DM 患者的 HCC 风险。结论 他汀类药物的使用可能对 HCC 的发展具有有益的抑制作用，特别是在具有 HCC 高风险的 DM 或 LC 患者中。概述 在这项基于全国人群的纵向巢式病例对照研究中，在亚洲人群中调查了他汀类药物使用与 HCC 风险之间的关联。在此，我们注意到使用他汀类药物对普通人群和 HCC 高危人群（即患有糖尿病或肝硬化的人群）发生 HCC 的有益影响。