HBV: comorbid DM tied to higher odds of HCC, death

  • Shyu YC & al.
  • J Viral Hepat
  • 9 Feb 2019

  • curated by Yael Waknine
  • Clinical Essentials
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Takeaway

  • 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.

Key results

  • 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).

Study design

  • 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.

Limitations

  • Observational design.
  • HBV treatment, viral load not captured.
  • Reliance on ICD-9 codes.

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