Glucose, Insulin, Insulin Resistance, and Hepatocellular Carcinoma in Male Hepatitis B Carriers
Date Issued
2009
Date
2009
Author(s)
Chao, Li-Ting
Abstract
Background: Nonalcoholic fatty liver disease is strongly associated with metabolic syndrome. In a recent animal model, increased expression of the hepatitis B virus (HBV) X protein can induce the accumulation of lipid in hepatocytes. By applying a case-cohort study, we aimed to evaluate the effects of both metabolic and viral factors on the development of hepatocellular carcinoma (HCC) among HBV carriers. aterials & Methods: Study subjects included a total of 1143 male HBV carriers (of whom 118 incident HCC cases were identified during follow-up) ages ≥30 years sampled from a cohort (1989-1992) of 2903 government employees who had been followed for 16 years. HBV genotype and prediagnostic viral load at multiple time points were measured by PCR-based methods. Unconditional logistic regression was used to determine the associations between metabolic and viral factors and HCC.esult: After adjusting for age at entry, cigarette smoking, alcohol consumption, diabetes and body mass index, baseline plasma concentrations of insulin (P=0.0016) and insulin resistance (P= 0.0226) were associated with progression from healthy HBV carrier state to HCC. The risk of incident HCC had a J-shaped association with the insulin concentrations, regardless of diabetes mellitus history. There were additive associations of viral load and higher insulin concentrations with HCC, such that the highest risk of HCC was found among individuals with both a high viral load of >5.91 copies/mL and a high insulin concentration or a high value of insulin resistance. However, we failed to find an association between baseline glucose levels in blood and HCC. onclusions: Prediagnostic plasma insulin, insulin resistance, and HBV DNA levels predict the risk of developing HCC.
Subjects
Insulin
glucose
hepatitis B virus
hepatocellular carcinoma
cohort
SDGs
Type
thesis
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