Increased risk of hepatocellular carcinoma in chronic hepatitis B patients with new onset diabetes: A nationwide cohort study
Journal
Alimentary Pharmacology and Therapeutics
Journal Volume
41
Journal Issue
11
Pages
1200-1209
Date Issued
2015
Author(s)
Abstract
Background Diabetes increases the risk of hepatocellular carcinoma (HCC), however, the time-relationship between hepatitis B virus and diabetes for the development of HCC remains unclear. Aim To explore the risk of HCC in chronic hepatitis B patients with newly diagnosed diabetes. Methods We conducted a nationwide cohort study by using Taiwanese National Health Insurance Research Database, which covers over 99% of entire population. Among randomly sampled one million enrollees, 14 523 chronic hepatitis B patients were diagnosed in years 1997-2009. We defined new onset diabetes as patients who were given the diagnosis in the years 1999-2009, but not in 1997-1998. The cohorts of chronic hepatitis B with new onset diabetes (n = 2099) and 1:1 ratio age-, gender-and inception point (onset date of diabetes)-matched nondiabetes (n = 2080) were followed up from the inception point until development of HCC, withdrawal from insurance or December 2009. Results After adjustment for competing mortality, patients with new onset diabetes had a significantly higher cumulative incidence of HCC [relative risk = 1.628, 95% confidence interval (CI) = 1.114-2.378, modified log-rank test, P = 0.012] as compared to nondiabetes patients. After adjustment for age, gender, hyperlipidaemia, chronic hepatitis B treatment, statins therapy, cirrhosis, comorbidity index and obesity, diabetes was still an independent predictor for HCC (hazard ratio = 1.798, 95% CI = 1.194-2.707, P = 0.005). Conclusion Chronic hepatitis B patients with newly diagnosed diabetes have an increased risk of hepatocellular carcinoma over time. ? 2015 John Wiley & Sons Ltd.
SDGs
Other Subjects
hydroxymethylglutaryl coenzyme A reductase inhibitor; adult; age; aged; Article; cancer incidence; cancer risk; chronic hepatitis B; cohort analysis; comorbidity; controlled study; diabetes mellitus; disease association; female; follow up; human; hyperlipidemia; liver cell carcinoma; liver cirrhosis; longitudinal study; major clinical study; male; middle aged; mortality; obesity; priority journal; sex difference; very elderly; Carcinoma, Hepatocellular; complication; diabetes mellitus; hepatitis B; Hepatitis B virus; incidence; isolation and purification; Liver Neoplasms; risk; virology; young adult; Adult; Aged; Aged, 80 and over; Carcinoma, Hepatocellular; Cohort Studies; Diabetes Mellitus; Female; Hepatitis B virus; Hepatitis B, Chronic; Humans; Incidence; Liver Cirrhosis; Liver Neoplasms; Male; Middle Aged; Risk; Young Adult
Type
journal article