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Type 2 diabetes and hepatocellular carcinoma: A cohort study in high prevalence area of hepatitis virus infection
Author(s) -
Lai MeiShu,
Hsieh MengShu,
Chiu YuehHsia,
Chen Tony HsiuHsi
Publication year - 2006
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.21208
Subject(s) - medicine , hepatocellular carcinoma , type 2 diabetes , diabetes mellitus , hepatitis c virus , hazard ratio , hepatitis c , incidence (geometry) , cohort study , hepatitis b virus , cohort , liver cancer , proportional hazards model , gastroenterology , immunology , virus , confidence interval , endocrinology , physics , optics
This study aimed to elucidate the relationship of type 2 diabetes, other known risk factors, and primary hepatocellular carcinoma (HCC) in countries with a high prevalence of hepatitis infection. We followed a prospective cohort of 54,979 subjects who participated in the Keelung Community‐Based Integrated Screening program between 1999 and 2002. A total of 5,732 subjects with type 2 diabetes cases were identified at enrollment on the basis of fasting blood glucose level, and a total of 138 confirmed HCC cases were identified either through two‐stage liver cancer screening or linkage with the National Cancer Registry. The independent effect of type 2 diabetes on the incidence of HCC and the interaction between type 2 diabetes and hepatitis infection or lipids profile were assessed using the Cox proportional hazards regression model. After controlling for age, sex, hepatitis B virus (HBV), hepatitis C virus (HCV), smoking, and alcohol consumption, the association between type 2 diabetes and incidence of HCC (excluding 33 prevalent cases identified at enrollment) was modified by HCV status and cholesterol level. The associations were only statistically significant (adjusted hazard ratio [HR] = 2.08 [1.03‐4.18]) for being HCV negative and for having hypercholesterolemia (adjusted HR = 2.81 [1.20‐6.55]). These statistically significant findings remained even excluding cases of diabetes newly diagnosed at enrollment. In conclusion , in an area with a high prevalence of hepatitis virus infection, type 2 diabetes increases the risk of developing HCC in those who are HCV negative or have a high level of total cholesterol. (H EPATOLOGY 2006;43: 1295–1302.)