The gut microbiome in diabetic patients with hepatocellular carcinoma: distinct bacterial compositional shifts after hepatitis C virus eradication.

Several near-significant associations in DHCCs included negative correlations between the PPAR signaling pathway and platelet count ( r = −0.47, p = 0.075) and between secondary bile acid biosynthesis and the international normalized ratio (INR) ( r = −0.58, p = 0.023). 4 Discussion Hepatocellular carcinoma in patients with diabetes mellitus represents a growing global health challenge, with emerging evidence suggesting that the gut microbiome plays a pivotal role in disease progression ( Dorrah et al., 2025 ; Ma et al., 2025 ).

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Several other associations, including lipoic acid metabolism with both total bilirubin ( r = 0.95, p = 0.012) and ALT ( r = −0.95, p = 0.011) and starch and sucrose metabolism with AST ( r = −0.84, p = 0.076) and FIB4 ( r = −0.82, p = 0.091), approached significance.

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