- Diabetes mellitus (DM) is associated with an excess risk for hepatocellular carcinoma (HCC) in patients with nonalcoholic steatohepatitis (NASH) cirrhosis.
Why this matters
- Diabetes was previously linked to an increased risk for cirrhosis in NASH.
- Older people with diabetes and low serum albumin should be carefully monitored for HCC.
- Study of 354 Mayo Clinic patients (41% male; 94% white; mean age, 61.5 years) with NASH cirrhosis, externally validated by a national registry cohort of 6630 liver transplant recipients.
- Funding: National Cancer Institute.
- Mayo Clinic: 71% of patients with NASH cirrhosis had diabetes.
- In median 47-month follow-up, 30 patients developed HCC; 27 had diabetes.
- 5-year cumulative incidence was higher with comorbid diabetes (10.2% vs 1.7%).
- Diabetes was tied to increased risk for HCC in univariate (HR, 3.62; P=.04) and multivariate analyses (HR, 4.18; P=.02).
- Other HCC risk factors: age (per decade: HR, 1.75; P=.008), low serum albumin (HR, 2.1; P<.01>
- Registry data: 58% of liver transplant recipients had diabetes.
- 291 developed HCC, including 191 with diabetes.
- 5-year cumulative rate was higher with diabetes (6.3% vs 4.6%).
- Registry data confirmed link of diabetes and increased risk for HCC in univariate (HR, 1.41; P=.005) and multivariate analyses (HR, 1.30; P=.03).
- Reliance on ICD-9 codes.