SynthesisBMC cancer2025

Statin use and risk of HCC in patients with MASLD and T2DM: an umbrella review and meta-analysis.

Nazanin Hosseinkhan, Laily Najafi, Soodeh Jahangiri, Zahra Emami, Mohammad E Khamseh

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in BMC cancer, 2025. The graph read 1 number from its abstract, feeding 1 cell of the map, but none could be read as for or against, so it casts no vote. Cited by 1 paper.

1number the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

Read, but not usablea number the graph found but could not read as for or against

HCC incidencestatin use vs no statin use, in patients with MASLDan association or prognostic statement, not a treatment comparison · liver, t2dfeeds one cell of the map
RR 0.890.56 to 1.40
However, the association was nonsignificant in patients with MASLD comprising five studies from one meta-analysis (RR: 0.89, 95% CI: [0.56, 1.40]).

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

Statins×liver & masld

No readable resultOpen on the map →What to test next →

4 readable studies in this cell: 0 favour the treatment, 2 find no difference, 2 favour the comparator.

Belief with this paper
0.00contested · 0 families support, 1 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the comparatorfavours the treatment →
0 · no effect
NCT002899002,340 enrolled · 2006
Δ -1.40-2.30 to -0.50
NCT01294683977 enrolled · 2011
Δ -0.21-1.43 to 0.94
NCT00559962260 enrolled · 2007
Δ 3.651.58 to 5.72

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

4 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

5 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
6 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

7 · Who and what money

Authors and funding

5 authors.

Nazanin Hosseinkhan *Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran, No 10, Firoozeh St, Vali Asr Sq.
Laily Najafi *Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran, No 10, Firoozeh St, Vali Asr Sq.
Soodeh JahangiriEndocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran, No 10, Firoozeh St, Vali Asr Sq.
Zahra EmamiEndocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran, No 10, Firoozeh St, Vali Asr Sq.
Mohammad E KhamsehEndocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran, No 10, Firoozeh St, Vali Asr Sq. khamseh.m@iums.ac.ir.ORCID http://orcid.org/0000-0003-4313-8440

Funding

No grant is acknowledged in the PubMed record.

8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

backgroundThe effect of statin use on hepatocellular carcinoma (HCC) in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) or type two diabetes mellitus (T2DM) is still unclear. In this umbrella review, we aimed to assess the available evidence for the association of statin use and HCC risk in the target population.

methodsWe carried out an umbrella review of previous systematic reviews/meta-analyses indexed in Cochrane, Embase, Scopus, and PubMed databases and published between Jan 1st, 2013, and Oct 22, 2024. We used random effects models to recalculate summary risk estimates for HCC incidence. Using A Measurement Tool to Assess methodological quality of systematic Review (AMSTAR2) tool, two independent reviewers evaluated each article for eligibility and methodologic quality and gathered data from the included studies.

resultsOf the initially identified 1,038 systematic reviews/meta-analyses, three non-overlapping studies with medium/high quality were included for qualitative synthesis. Statin use in people with T2DM was reported in six studies belonging to two meta-analyses. The results showed that statins were associated with a decreased risk of HCC (RR: 0.16, 95% CI: [0.03, 0.98]). However, the association was nonsignificant in patients with MASLD comprising five studies from one meta-analysis (RR: 0.89, 95% CI: [0.56, 1.40]).

conclusionStatin use is associated with a decreased incidence of HCC in people with T2DM. In patients with MASLD, the association is not significant. However, the effects of other variables including the stage of inflammation and/or liver fibrosis on the outcome need to be explored in future studies.

Indexed as

Carcinoma, HepatocellularDiabetes Mellitus, Type 2Fatty LiverHydroxymethylglutaryl-CoA Reductase InhibitorsLiver NeoplasmsHumansIncidenceRisk FactorsHydroxymethylglutaryl-CoA Reductase InhibitorsHepatocellular carcinomaMetabolic dysfunction–associated steatotic liver diseaseStatinType 2 diabetes mellitus

Identifiers

PMID40369443
PMCPMC12080120

What Socratic holds

Texttitle and abstract
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.