Zhang Wei-Shuo, Li Xiao-Ou, Zhang Hui, Gao Chun, Fang Long, Yang Hua-Yuan
Department of Gastroenterology, China-Japan Friendship Hospital, Ministry of Health, Beijing 100029, People's Republic of China.
Department of Gastroenterology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, People's Republic of China.
Diabetes Metab Syndr Obes. 2020 Jun 15;13:1979-1988. doi: 10.2147/DMSO.S251943. eCollection 2020.
More than 50% of patients with type 2 diabetes mellitus (DM) also have hypertension. Moreover, hypertension has been regarded as one paraneoplastic phenomenon of hepatocellular carcinoma (HCC). Our study was designed to determine the relationship between blood pressure and DM in HCC patients.
A total of 879 HCC patients were included and 151 (17.2%) were diagnosed with DM. Multivariable logistic regression analysis was used to determine the relationship and the results were expressed as adjusted odds ratios (AORs) and their 95% confidence intervals (CIs). Considering the effect of potential confounders, sub-group analysis was performed. We would further study the association of systolic blood pressure (SBP) with fasting glucose, and the association between DM duration/treatment and SBP level.
Compared with non-diabetic patients, the diabetic patients had increased levels of SBP (133.7±18.5 mmHg vs 128.3±15.2 mmHg, P=0.001) and fasting blood glucose (9.13±3.04 mmol/L vs 5.18±1.08 mmol/L, P<0.001), an elder age (58.5±10.2 years vs 55.3±11.2 years, P=0.001), a higher percentage of cirrhosis diagnosis (60.9% vs 48.2%, P=0.004), lower percentages of drinking (18.5% vs 30.8%, P=0.002) and smoking (30.5% vs 43.7%, P=0.003), and decreased levels of GGT (median/interquartile-range 88/53-177 U/L vs 117/58-248 U/L, P=0.037), platelet count (121.4±76.6 ×10/L vs 151.2±82.8 ×10/L, P<0.001) and hemoglobin (124.3±25.5 g/L vs 133.6±24.2 g/L, P<0.001). Multivariable analysis showed that, statistically significant differences were found for SBP ≥140 mmHg (AOR=2.101; 95% CI, 1.424-3.100; P<0.001), smoking (AOR=0.637; 95% CI, 0.415-0.979; P=0.040), hemoglobin (AOR=0.990; 95% CI, 0.983-0.998; P=0.010) and platelet count (AOR=0.996; 95% CI, 0.994-0.999; P=0.009). For the relationship between SBP and DM, the positive result was supported by most (10/14) of the subgroup analyses.
SBP level was increased in HCC patients with diabetes mellitus.
超过50%的2型糖尿病（DM）患者同时患有高血压。此外，高血压被视为肝细胞癌（HCC）的一种副肿瘤现象。我们的研究旨在确定HCC患者血压与DM之间的关系。
共纳入879例HCC患者，其中151例（17.2%）被诊断为DM。采用多变量逻辑回归分析来确定两者之间的关系，结果以调整后的比值比（AORs）及其95%置信区间（CIs）表示。考虑到潜在混杂因素的影响，进行了亚组分析。我们将进一步研究收缩压（SBP）与空腹血糖的关联，以及DM病程/治疗与SBP水平之间的关联。
与非糖尿病患者相比，糖尿病患者的SBP水平升高（133.7±18.5 mmHg对128.3±15.2 mmHg，P=0.001）、空腹血糖升高（9.13±3.04 mmol/L对5.18±1.08 mmol/L，P<0.001）、年龄较大（58.5±10.2岁对55.3±11.2岁，P=0.001）、肝硬化诊断百分比更高（60.9%对48.2%，P=0.004）、饮酒（18.5%对30.8%，P=0.002）和吸烟（30.5%对43.7%，P=0.003）百分比更低，以及γ-谷氨酰转移酶（GGT）水平降低（中位数/四分位数间距88/53 - 177 U/L对117/58 - 248 U/L，P=0.037）、血小板计数（121.4±76.6×10⁹/L对 151.2±82.8×10⁹/L，P<0.001）和血红蛋白（124.3±25.5 g/L对133.6±24.2 g/L，P<0.001）水平降低。多变量分析显示, SBP≥140 mmHg（AOR=2.101；95% CI，1.424 - 3.100；P<0.001）、吸烟（AOR=0.637；95% CI，0.415 - 0.979；P=0.040）、血红蛋白（AOR=0.990；95% CI，0.983 - 0.998；P=0.010）和血小板计数（AOR=0.996；95% CI，0.994 - 0.999；P=0.009）存在统计学显著差异。对于SBP与DM之间的关系，大多数（10/14）亚组分析支持阳性结果。
糖尿病的HCC患者SBP水平升高。
