- Diabetes mellitus (DM) is an independent risk factor for hepatocellular carcinoma (HCC), HCC-related mortality, and all-cause mortality among patients with chronic HBV, according to data from a Taiwanese population-based cohort study.
Why this matters
- This is the first study to estimate the temporal relationship between DM and HCC, and transition to mortality.
- Over an 11-year follow-up, rates for HCC, HCC mortality, and overall mortality were 11.8%, 6.1%, and 12.3%, respectively.
- HBV patients with vs without DM had higher rates of:
- HCC (13.3% vs 10%).
- HCC mortality (7.5% vs 4.7%).
- Overall mortality (16.9% vs 8.2%; all P<.001>
- Risk gap between patients with/without DM widened over time.
- In multivariate transition-specific Cox analysis accounting for cirrhosis and other factors, HBV patients with DM had:
- 35% higher risk for HCC development (aHR=1.35; 95% CI, 1.16-1.57).
- 31% higher risk for HCC mortality (aHR=1.31; 95% CI, 1.06-1.62).
- More than doubled risk for all-cause mortality (aHR=2.32; 95% CI, 1.84-2.92).
- 2966 patients with HBV and newly diagnosed DM in 2000, derived from the Longitudinal Cohort of Diabetes Patients, were propensity-matched with non-DM patients from the Taiwanese National Health Insurance Research Database.
- Funding: Chang Gung Medical Research Council, Taiwan.
- Observational design.
- HBV treatment, viral load not captured.
- Reliance on ICD-9 codes.