Taiwanese patients suffering with chronic hepatitis B virus infection (HBV) and recently diagnosed with diabetes had a higher risk of developing hepatocellular carcinoma, according to recent findings published in the Alimentary Pharmacology and Therapeutics journal under the title “Increased risk of hepatocellular carcinoma in chronic hepatitis B patients with new onset diabetes: a nationwide cohort study.”
“In 2012, diabetes resulted in 1.5 million deaths and it became the [eighth] leading cause of death. 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,” explained the researchers.
The researchers studied a cohort throughout the entire country and used the Taiwanese National Health Insurance Research Database to assess data belonging to patients with HBV and new onset diabetes. From all the database records, 2,099 patients with chronic HBV were identified, and recent onset diabetes were matched with 2,080 individuals suffering with HBV without diabetes; researchers followed these patients from the inception point the development of hepatocellular carcinoma (HCC) or the withdrawal from insurance or December 2009.
A larger proportion of individuals with diabetes also developed HCC in comparison to those patients without diabetes (3.29% vs. 2.02%; P = .011). People with new onset diabetes had a higher cumulative incident rate of HCC (RR = 1.628; 95% CI, 1.114–2.378; P = .012) in comparison to patients that did not have diabetes, after adjusting for competing mortality.
In comparison to patients without diabetes, patients with diabetes had hyperlipidaemia (60.6% vs. 33.51%; P < .001), obesity (5.56% vs. 1.88%; P < .001) and cirrhosis (16.29% vs. 12.88%; P = .002).
After taking into account for age, hyperlipidaemia, gender, chronic HBV therapy, cirrhosis, statins therapy, comorbidity index and obesity, diabetes seemed to be an independent factor of prediction 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. 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,” concluded the researchers.