Chen Tzu-I, Lee Fu-Jen, Hsu Wan-Lun, Chen Yong-Chen, Chen Mingchih
Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, New Taipei City 242062, Taiwan.
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Fu Jen Catholic University Hospital, New Taipei City 24352, Taiwan.
Cancers (Basel). 2023 Feb 10;15(4):1148. doi: 10.3390/cancers15041148.
Previous studies have indicated that HBV infection and T2DM are the factors that increase the risk of developing HCC. The experimental evidence has shown that antiglycemic agents may reduce the risk of HCC. However, the effect of dipeptidyl peptidase-4 inhibitors (DPP-4 inhibitors) on the risk of HCC in T2DM patients with chronic HBV infection remains unclear. In this retrospective cohort study, we extracted patients with T2DM and chronic HBV infection from the National Health Insurance Research Database (NHIRD) in Taiwan. The cases were divided into DPP-4 inhibitors use and non-use groups, according to whether they received DPP-4 inhibitors treatment, and the risk of HCC was compared between the two groups. At the end of the follow-up, approximately 2.33% of DPP-4 inhibitors users had received an HCC diagnosis compared with 3.33% of non-DPP-4 inhibitors users ( < 0.0001). After multivariate adjustment, DPP-4 inhibitors users showed a significant reduction in HCC risk (adjusted hazard ratios (aHRs): 0.53; 95% confidence intervals (CIs): 0.44-0.65). In conclusion, this population-based retrospective cohort study indicated that, in T2DM patients with chronic HBV infection, the use of DPP-4 inhibitors significantly reduced the risk of developing HCC compared with non-DPP-4 inhibitors use.
既往研究表明，乙肝病毒（HBV）感染和2型糖尿病（T2DM）是增加肝细胞癌（HCC）发生风险的因素。实验证据显示，降糖药物可能降低HCC风险。然而，二肽基肽酶-4抑制剂（DPP-4抑制剂）对慢性HBV感染的T2DM患者发生HCC风险的影响仍不明确。在这项回顾性队列研究中，我们从台湾国民健康保险研究数据库（NHIRD）中提取了慢性HBV感染的T2DM患者。根据是否接受DPP-4抑制剂治疗，将病例分为DPP-4抑制剂使用组和非使用组，并比较两组发生HCC的风险。随访结束时，约2.33%的DPP-4抑制剂使用者被诊断为HCC，而非DPP-4抑制剂使用者为3.33%（<0.0001）。多因素调整后，DPP-4抑制剂使用者的HCC风险显著降低（调整后风险比（aHRs）：0.53；95%置信区间（CIs）：0.44-0.65）。总之，这项基于人群的回顾性队列研究表明，在慢性HBV感染的T2DM患者中，与未使用DPP-4抑制剂相比，使用DPP-4抑制剂可显著降低发生HCC的风险。
