Li Xu, Xu Hongqin, Gao Yang, Pan Meng, Wang Le, Gao Pujun
Department of Hepatology, The First Hospital of Jilin University, Jilin University Jilin Province Key Laboratory of Infectious Disease, Laboratory of Molecular Virology Department of Neurology, The First Hospital of Jilin University, Jilin University, Changchun, China.
Medicine (Baltimore). 2017 Mar;96(13):e6508. doi: 10.1097/MD.0000000000006508.
We investigated the link between diabetes mellitus (DM) and hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) risk in treatment-naïve chronic hepatitis C (CHC) patients in China.To examine the association between DM and HCC, we conducted a case-control study of 300 Chinese CHC patients with HCC, compared to an age- and sex-matched control group of 517 CHC patients not diagnosed with HCC.We found that DM was more prevalent in the HCC patient group (18.7%) than in the CHC-only patient group (10.8%). We conducted logistic regression analyses adjusting for demographics features and other HCC risk factors and found that DM increased the risk of HCC development nearly 2-fold [adjusted odds ratio (AOR), 95% confidence interval (95% CI), 1.80 (1.17-2.75)]. Meanwhile, the proportion of HCC patients and CHC-only patients with liver cirrhosis were 79.3% and 46.2%, respectively, yielding an AOR of 4.62 (95% CI, 3.31-6.46). Multivariate analyses comparing the risk of HCV-related HCC development in DM patients with and without liver cirrhosis revealed that the estimated AOR (95% CI) for those with liver cirrhosis was 5.60 (2.25-13.96). However, the HCC risk decreased significantly with a later age of diabetes onset (AOR [95% CI], 0.94 [0.89-0.99]).DM was associated with an increased risk for HCC development in treatment-naïve CHC patients in China. Furthermore, liver cirrhosis and an early DM diagnoses further increased the risks of HCC development in patients diagnosed with both CHC and DM.
我们在中国初治的慢性丙型肝炎（CHC）患者中，研究了糖尿病（DM）与丙型肝炎病毒（HCV）相关肝细胞癌（HCC）风险之间的联系。为了检验DM与HCC之间的关联，我们对300例中国CHC合并HCC患者进行了病例对照研究，并与517例未诊断为HCC的年龄和性别匹配的CHC患者对照组进行比较。我们发现，DM在HCC患者组（18.7%）中比仅患CHC的患者组（10.8%）更为普遍。我们进行了逻辑回归分析，对人口统计学特征和其他HCC风险因素进行了调整，发现DM使HCC发生风险增加近2倍[调整后的优势比（AOR），95%置信区间（95%CI），1.80（1.17 - 2.75）]。同时，HCC患者和仅患CHC患者中肝硬化的比例分别为79.3%和46.2%，AOR为4.62（95%CI，3.31 - 6.46）。多变量分析比较了有和没有肝硬化的DM患者中HCV相关HCC发生风险，结果显示，有肝硬化患者的估计AOR（95%CI）为5.60（2.25 - 13.96）。然而，随着糖尿病发病年龄的增加，HCC风险显著降低（AOR[95%CI]，0.94[0.89 - 0.99]）。在中国初治的CHC患者中，DM与HCC发生风险增加相关。此外，肝硬化和糖尿病的早期诊断进一步增加了同时诊断为CHC和DM患者发生HCC的风险。
