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World J Hepatol. May 18, 2015; 7(8): 1105-1111
Published online May 18, 2015. doi: 10.4254/wjh.v7.i8.1105
Prevention of hepatocellular carcinoma by correction of metabolic abnormalities: Role of statins and metformin
Javier Ampuero, Manuel Romero-Gomez
Javier Ampuero, Manuel Romero-Gomez, Unit for the Clinical Management of Digestive Diseases, Valme University Hospital, 41014 Sevilla, Spain
Author contributions: Ampuero J and Romero-Gomez M contributed to this paper.
Conflict-of-interest: No conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Javier Ampuero, MD, PhD, Unit for the Clinical Management of Digestive Diseases, Valme University Hospital, Avenida de Bellavista s/n, 41014 Sevilla, Spain. javi.ampuero@gmail.com
Telephone: +34-955-015761 Fax: +34-955-015899
Received: August 17, 2014
Peer-review started: August 18, 2014
First decision: September 16, 2014
Revised: January 18, 2015
Accepted: January 30, 2015
Article in press: February 2, 2015
Published online: May 18, 2015
Core Tip

Core tip: Hepatocellular carcinoma is the result of a complex process which impairs several pathways, such as RAS/RAF/mitogen-activated protein kinase kinase/extracellular-signal-regulated kinase, phosphatidylinositol-4,5-bisphosphate 3-kinase/AKT/mammalian target of rapamycin and Wnt/β-catenin signaling. Patients showing metabolic syndrome seem to have higher incidence and mortality rates from hepatocellular carcinoma than healthy subjects, especially those with type 2 diabetes mellitus and obesity. Thus, metformin and statins, both to treat features of metabolic syndrome, have been proposed to decrease the risk of hepatocellular carcinoma. Metformin (by decreasing hyperglycemia state through 5′-adenosine monophosphate-activated protein kinase pathway activation) and statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) show anti-tumoral properties modifying several steps of the crucial signaling cascades.