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2型糖尿病特征影响慢性乙型肝炎肝硬化患者肝细胞癌的发生。

Type 2 diabetes mellitus characteristics affect hepatocellular carcinoma development in chronic hepatitis B patients with cirrhosis.

作者信息

Li Man-Yu, Li Ting-Ting, Li Ke-Jian, Zhou Cheng

机构信息

Division I of In Vitro Diagnostics for Infectious Diseases, Institute for In Vitro Diagnostics Control, National Institutes for Food and Drug Control, Beijing 100050, China.

Department of Clinical Laboratory, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China.

出版信息

World J Clin Cases. 2023 Feb 16;11(5):1009-1018. doi: 10.12998/wjcc.v11.i5.1009.

Abstract

BACKGROUND

Type 2 diabetes mellitus (T2DM) has been shown to be correlated with hepatocellular carcinoma (HCC) development. However, further investigation is needed to understand how T2DM characteristics affect the prognosis of chronic hepatitis B (CHB) patients.

AIM

To assess the effect of T2DM on CHB patients with cirrhosis and to determine the risk factors for HCC development.

METHODS

Among the 412 CHB patients with cirrhosis enrolled in this study, there were 196 with T2DM. The patients in the T2DM group were compared to the remaining 216 patients without T2DM (non-T2DM group). Clinical characteristics and outcomes of the two groups were reviewed and compared.

RESULTS

T2DM was significantly related to hepatocarcinogenesis in this study ( = 0.002). The presence of T2DM, being male, alcohol abuse status, alpha-fetoprotein > 20 ng/mL, and hepatitis B surface antigen > 2.0 log IU/mL were identified to be risk factors for HCC development in the multivariate analysis. T2DM duration of more than 5 years and treatment with diet control or insulin ± sulfonylurea significantly increased the risk of hepatocarcinogenesis.

CONCLUSION

T2DM and its characteristics increase the risk of HCC in CHB patients with cirrhosis. The importance of diabetic control should be emphasized for these patients.

摘要

背景

2型糖尿病(T2DM)已被证明与肝细胞癌(HCC)的发生相关。然而,需要进一步研究以了解T2DM的特征如何影响慢性乙型肝炎(CHB)患者的预后。

目的

评估T2DM对CHB肝硬化患者的影响,并确定HCC发生的危险因素。

方法

在本研究纳入的412例CHB肝硬化患者中,有196例患有T2DM。将T2DM组患者与其余216例无T2DM的患者(非T2DM组)进行比较。回顾并比较两组的临床特征和结局。

结果

在本研究中,T2DM与肝癌发生显著相关(P = 0.002)。在多变量分析中,T2DM的存在、男性、酗酒状态、甲胎蛋白>20 ng/mL以及乙肝表面抗原>2.0 log IU/mL被确定为HCC发生的危险因素。T2DM病程超过5年以及采用饮食控制或胰岛素±磺脲类药物治疗显著增加了肝癌发生的风险。

结论

T2DM及其特征增加了CHB肝硬化患者发生HCC的风险。对于这些患者,应强调糖尿病控制的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be44/9979280/54ec1ef3fa72/WJCC-11-1009-g001.jpg

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