Type 2 diabetes and hepatocellular carcinoma: A case-control study in patients with chronic hepatitis B

• Published in: International journal of cancer Vol. 131; no. 5; pp. 1197 - 1202
• Main Authors: Li, Qiang, Li, Wen-Wen, Yang, Xia, Fan, Wen-Bo, Yu, Jin-Hong, Xie, Shuang-Shuang, Liu, Li, Ma, Li-Xian, Chen, Shi-Jun, Kato, Naoya
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.09.2012; Wiley-Blackwell; Wiley Subscription Services, Inc
• Subjects: Adult; Age; Biological and medical sciences; Cancer; Carcinoma, Hepatocellular - epidemiology; Carcinoma, Hepatocellular - etiology; Case-Control Studies; China - epidemiology; Cross-Sectional Studies; Diabetes; Diabetes Complications - epidemiology; Diabetes Complications - etiology; Diabetes Mellitus, Type 2 - physiopathology; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; gender; Hepatitis; hepatitis B; Hepatitis B e Antigens - metabolism; Hepatitis B virus; Hepatitis B virus - isolation & purification; Hepatitis B, Chronic - complications; hepatocellular carcinoma; Humans; Liver cancer; Liver cirrhosis; Liver Neoplasms - epidemiology; Liver Neoplasms - etiology; Male; Medical research; Medical sciences; Middle Aged; Neoplasm Staging; Prevalence; Prognosis; Prospective Studies; Risk Factors; Tumors; Type 2 diabetes; China; Endocrinopathy; Type 2 diabetes; Human; gender; hepatitis B; Sex; Metabolic diseases; Hepatic disease; Hepatocellular carcinoma; Malignant tumor; Case control study; Infection; Viral hepatitis B; Liver cancer; Cancerology; Viral disease; Digestive diseases; Cancer
• ISSN: 0020-7136; 1097-0215
• DOI: 10.1002/ijc.27337

Type 2 diabetes has been suggested as an independent risk factor for the development of hepatocellular carcinoma (HCC). However, the role of Type 2 diabetes on the development of HCC in the presence of chronic hepatitis B (CHB) remains inconclusive. We conducted this hospital‐based case–control study to evaluate the roles of Type 2 diabetes in HCC development in patients with CHB. From January 2004 to December 2008, a total of 6,275 eligible consecutive patients with chronic hepatitis B virus (HBV) infection were recruited. A total of 1,105 of them were patients with HBV‐related HCC and 5,170 patients were CHB but without HCC. We used multivariate logistic regression models to investigate the association between Type 2 diabetes and HCC risk. The prevalence of Type 2 diabetes is higher among HCC patients without cirrhosis than among those with cirrhosis (12.1% vs. 6.7%, p = 0.003). Type 2 diabetes was associated with a significantly high risk of HCC in female patients after adjusting for age, family history of HCC, city of residence, hepatitis B e antigen and cirrhosis with an odds ratio (95% confidence interval, CI) of 1.9 (1.1–3.4). Restricted analyses among female patients without cirrhosis indicated that Type 2 diabetes was strongly associated with HCC risk with adjusted odds ratio (95% CI) of 5.6 (2.2–14.1). In conclusion, Type 2 diabetes is independently associated with the increased risk of HCC in female CHB patients. Female CHB patients with Type 2 diabetes are of a high HCC risk population and should be considered for HCC close surveillance program.