丙型肝炎肝硬化合并糖尿病患者患肝细胞癌的风险增加。
Increased risk of hepatocellular carcinoma among patients with hepatitis C cirrhosis and diabetes mellitus.
作者信息
Veldt Bart J, Chen Wendong, Heathcote E Jenny, Wedemeyer Heiner, Reichen Juerg, Hofmann W Peter, de Knegt Robert J, Zeuzem Stefan, Manns Michael P, Hansen Bettina E, Schalm Solko W, Janssen Harry L A
机构信息
Erasmus MC University Medical Center, Department of Gastroenterology and Hepatology, Rotterdam, the Netherlands.
出版信息
Hepatology. 2008 Jun;47(6):1856-62. doi: 10.1002/hep.22251.
UNLABELLED
Recent studies suggest that diabetes mellitus increases the risk of developing hepatocellular carcinoma (HCC). The aim of this study is to quantify the risk of HCC among patients with both diabetes mellitus and hepatitis C in a large cohort of patients with chronic hepatitis C and advanced fibrosis. We included 541 patients of whom 85 (16%) had diabetes mellitus. The median age at inclusion was 50 years. The prevalence of diabetes mellitus was 10.5% for patients with Ishak fibrosis score 4, 12.5% for Ishak score 5, and 19.1% for Ishak score 6. Multiple logistic regression analysis showed an increased risk of diabetes mellitus for patients with an elevated body mass index (BMI) (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.00-1.11; P = 0.060) and a decreased risk of diabetes mellitus for patients with higher serum albumin levels (OR, 0.81; 95% CI, 0.63-1.04; P = 0.095). During a median follow-up of 4.0 years (interquartile range, 2.0-6.7), 11 patients (13%) with diabetes mellitus versus 27 patients (5.9%) without diabetes mellitus developed HCC, the 5-year occurrence of HCC being 11.4% (95% CI, 3.0-19.8) and 5.0% (95% CI, 2.2-7.8), respectively (P = 0.013). Multivariate Cox regression analysis of patients with Ishak 6 cirrhosis showed that diabetes mellitus was independently associated with the development of HCC (hazard ratio, 3.28; 95% CI, 1.35-7.97; P = 0.009).
CONCLUSION
For patients with chronic hepatitis C and advanced cirrhosis, diabetes mellitus increases the risk of developing HCC.
未标注
近期研究表明，糖尿病会增加肝细胞癌（HCC）的发病风险。本研究旨在量化一大群慢性丙型肝炎和晚期纤维化患者中，同时患有糖尿病和丙型肝炎的患者发生HCC的风险。我们纳入了541例患者，其中85例（16%）患有糖尿病。纳入时的中位年龄为50岁。Ishak纤维化评分为4分的患者中糖尿病患病率为10.5%，Ishak评分为5分的患者中为12.5%，Ishak评分为6分的患者中为19.1%。多因素逻辑回归分析显示，体重指数（BMI）升高的患者患糖尿病的风险增加（比值比[OR]，1.05；95%置信区间[CI]，1.00 - 1.11；P = 0.060），而血清白蛋白水平较高的患者患糖尿病的风险降低（OR，0.81；95% CI，0.63 - 1.04；P = 0.095）。在中位随访4.0年（四分位间距，2.0 - 6.7年）期间，11例（13%）糖尿病患者与27例（5.9%）非糖尿病患者发生了HCC，HCC的5年发生率分别为11.4%（95% CI，3.0 - 19.8）和5.0%（95% CI，2.2 - 7.8）（P = 0.013）。对Ishak 6级肝硬化患者的多因素Cox回归分析显示，糖尿病与HCC的发生独立相关（风险比，3.28；95% CI，1.35 - 7.97；P = 0.009）。
结论
对于慢性丙型肝炎和晚期肝硬化患者，糖尿病会增加发生HCC的风险。
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