https://scholars.lib.ntu.edu.tw/handle/123456789/393912
標題: | Increased risk of hepatocellular carcinoma in chronic hepatitis B patients with new onset diabetes: A nationwide cohort study | 作者: | Fu S.-C. Huang Y.-W. Wang T.-C. Hu J.-T. DING-SHINN CHEN Yang S.-S. |
公開日期: | 2015 | 卷: | 41 | 期: | 11 | 起(迄)頁: | 1200-1209 | 來源出版物: | Alimentary Pharmacology and Therapeutics | 摘要: | 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. |
URI: | http://www.scopus.com/inward/record.url?eid=2-s2.0-84929132837&partnerID=MN8TOARS http://scholars.lib.ntu.edu.tw/handle/123456789/393912 |
DOI: | 10.1111/apt.13191 | SDG/關鍵字: | 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 |
顯示於: | 醫學系 |
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