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Diabetes increases risk for HCC in adults with HBV

Taiwanese patients with chronic hepatitis B virus infection and newly diagnosed diabetes had an increased risk for hepatocellular carcinoma over time, according to study findings.

“In 2012, diabetes resulted in 1.5 million deaths and it became the [eighth] leading cause of death,” the researchers wrote. “Studies had shown that diabetes increased the risk of [hepatocellular carcinoma]. Although several studies disclosed the association between diabetes and [hepatocellular carcinoma] in chronic hepatitis B patients, the time-relationship between HBV and diabetes for [hepatocellular carcinoma] development remains unclear.”

The researchers conducted a nationwide cohort study using the Taiwanese National Health Insurance Research Database to analyze data of patients with HBV and new onset diabetes. Of all patients enrolled in the database, 2,099 patients with chronic HBV and new onset diabetes were matched with 2,080 patients with HBV without diabetes, and were followed by researchers from the inception point until either the development of hepatocellular carcinoma (HCC), withdrawal from insurance or December 2009, according to the research.

A higher proportion of patients with diabetes also developed HCC compared with patients without diabetes (3.29% vs. 2.02%; P = .011). Patients with new onset diabetes had a higher cumulative incident rate of HCC (RR = 1.628; 95% CI, 1.114–2.378; P = .012) compared with patients without diabetes, after adjusting for competing mortality.

Compared with patients without diabetes, patients with diabetes had hyperlipidaemia (60.6% vs. 33.51%; P < .001), cirrhosis (16.29% vs. 12.88%; P = .002) and obesity (5.56% vs. 1.88%; P < .001).

After adjusting for age, gender, hyperlipidaemia, chronic HBV therapy, statins therapy, cirrhosis, comorbidity index and obesity, diabetes was found to be an independent predictor for HCC

(HR = 1.798; 95% CI, 1.194–2.707; P = .005).

“Chronic hepatitis B patients who develop diabetes during follow-up are at an increased risk of HCC over time,” the researchers concluded. “Every effort should be made in prevention of diabetes in chronic hepatitis B patients to lower the risk of HCC. New onset diabetes in chronic hepatitis B patients should be actively treated as a part of prevention of HCC.” – by Melinda Stevens

Disclosure: The researchers report no relevant financial disclosures.