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Diabetes poses a higher risk of hepatocellular carcinoma and mortality in patients with chronic hepatitis B: A population‐based cohort study
Author(s) -
Shyu YuChiau,
Huang TingShuo,
Chien ChengHung,
Yeh ChauTing,
Lin ChihLang,
Chien RongNan
Publication year - 2019
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/jvh.13077
Subject(s) - medicine , hepatocellular carcinoma , hazard ratio , cohort , diabetes mellitus , cirrhosis , liver disease , cohort study , proportional hazards model , risk factor , cause of death , gastroenterology , disease , confidence interval , endocrinology
Summary Diabetes mellitus may be a risk factor of HCC development in chronic hepatitis B infected patients and affect the all‐cause mortality. This study aimed to examine whether DM was associated with the development of HCC with CHB and affected the all‐cause mortality. A total of 2966 CHB patients newly diagnosed with DM in 2000 were retrieved from the Longitudinal Cohort of Diabetes Patients database and used propensity scores matching based on age, sex‐gender, alcohol‐related liver disease and baseline liver cirrhosis to compare with the non‐DM patients from the Taiwanese National Health Insurance Research Database. The CHB patients with DM compared to the non‐DM had significantly increased (3.3%) risk for HCC development and significantly increased (2.8%) risk of HCC‐related mortality. Interestingly, the all‐cause mortality was significantly higher in the DM cohort (16.9%) compared to the non‐DM cohort (8.2%). In a multivariable transition‐specific Cox model to investigate the adjusted hazard ratio of CHB patients with DM or non‐DM during the transitions from start to HCC was 1.35; 95% CI (1.16‐1.57) and from HCC to death was 1.31; 95% CI (1.06‐1.62). All‐cause mortality between CHB patients with DM or non‐DM during the transitions from start to death was 2.32; 95% CI (1.84‐2.92). Taken together, DM is an independent risk factor associated with increasing disease development of HCC, HCC‐related mortality and all‐cause mortality in CHB patients. This study may provide a clinical strategy for strict DM control in order to reduce the risk of disease development in CHB patients.