https://scholars.lib.ntu.edu.tw/handle/123456789/496110
標題: | Type 2 diabetes, smoking, insulin use, and mortality from hepatocellular carcinoma: A 12-year follow-up of a national cohort in Taiwan | 作者: | CHIN-HSIAO TSENG | 公開日期: | 2013 | 卷: | 7 | 期: | 2 | 起(迄)頁: | 693-702 | 來源出版物: | Hepatology International | 摘要: | Background: The effect of smoking and insulin use in the association between diabetes and hepatocellular carcinoma (HCC) is not known. Materials and methods: Age-standardized HCC mortality trends during 1995-2006 in the general population were calculated. A total of 88,694 type 2 diabetic patients aged ?25 years recruited in 1995-1998 were followed till 2006. Age- and sex-specific mortality rates and the mortality rate ratios (vs. the average mortality rates in the general population) were calculated. Risk factors were evaluated by Cox regression. Results: The age-standardized mortality trend slightly increased significantly in women but was steady in men. For diabetic patients aged ?25 years, 830 men and 515 women died of HCC during 1995-2006. Mortality rate ratios (95 % confidence interval) were larger with the decreasing age: 7.36 (6.52, 8.31), 2.48 (2.22, 2.78), 1.79 (1.59, 2.02), and 1.87 (1.51, 2.32) for age 25-54, 55-64, 65-74, and ?75 years for men, respectively, 10.12 (7.73, 13.25), 4.08 (3.57, 4.67), 2.45 (2.15, 2.78), and 1.71 (1.34, 2.19) for women. Age, male sex, lower BMI, smoking, and insulin use were associated with HCC mortality, but diabetes duration was not. Smoking and insulin use carried a significantly higher risk of 22-29 % and 37-58 %, respectively, without interaction. A dose-responsive pattern between the duration of insulin use and HCC mortality was noted, with a relative risk of 1.5-1.7 in those who used insulin for ?10 years. Conclusions: Diabetic patients have a higher risk of HCC mortality, which is more remarkable in the younger age. Smoking and insulin are potentially modifiable risk factors. ? 2012 Asian Pacific Association for the Study of the Liver. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84879842443&doi=10.1007%2fs12072-012-9405-0&partnerID=40&md5=d3dcd13349e56f3e9c2e4b54fd337d83 https://scholars.lib.ntu.edu.tw/handle/123456789/496110 |
ISSN: | 1936-0533 | DOI: | 10.1007/s12072-012-9405-0 | SDG/關鍵字: | insulin; adult; age distribution; aged; article; body mass; cancer mortality; clinical evaluation; cohort analysis; controlled study; drug effect; drug use; ethnic group; female; follow up; high risk patient; human; liver cell carcinoma; major clinical study; male; non insulin dependent diabetes mellitus; population research; priority journal; risk assessment; risk factor; sex difference; smoking habit; Taiwan; treatment duration; trend study |
顯示於: | 醫學系 |
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