Ting-Shuo Huang1,2,3, Chih-Lang Lin3,4,5, Mu-Jie Lu3, Chau-Ting Yeh5,6,7, Kung-Hao Liang6, Chi-Chin Sun2,8, Yu-Chiau Shyu3,9, Rong-Nan Chien3,4,5. 1. Department of General Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan. 2. Department of Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan. 3. Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, Taiwan. 4. Liver Research Unit, Chang Gung Memorial Hospital, Keelung, Taiwan. 5. College of Medicine, Chang Gung University, Taoyuan, Taiwan. 6. Liver Research Center, Chang Gung Memorial Hospital, Taipei, Taiwan. 7. Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan. 8. Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan. 9. Institute of Molecular Biology, Academia Sinica, Taipei, Taiwan.
Abstract
BACKGROUND AND AIM: The effect of diabetes mellitus (DM) on the development of hepatocellular carcinoma (HCC) and all-cause mortality after HCC development in chronic hepatitis C virus (HCV)-infected patients remains inconclusive. This cohort study aimed to investigate these issues using the Taiwanese National Health Insurance Research Database. METHODS: We retrieved and enrolled newly diagnosed DM patients with HCV from the Longitudinal Cohort of Diabetes Patients database. Propensity score matching-including age, sex, alcohol-related liver disease, and baseline liver cirrhosis-was used to identify and enroll HCV patients without DM from the Longitudinal Health Insurance Database (n = 1686). A multi-state model was used to investigate transitions from "start-to-HCC," "start-to-death," and "HCC-to-death." RESULTS: The multi-state model showed higher cumulative hazards for "start-to-HCC," "start-to-death," and "HCC-to-death" transitions in the DM (vs non-DM) cohort. The cumulative probability of death with or without HCC after 10 years of follow-up was higher in the DM cohort than in the non-DM cohort. Multivariable transition-specific Cox models demonstrated that DM significantly increased the risk for transition from "start-to-HCC" (adjusted hazard ratio [aHR] 1.36; 95% confidence interval [CI] 1.16-1.59; P < 0.001), "start-to-death" (aHR 2.61; 95% CI: 2.05-3.33; P < 0.001), and "HCC-to-death" (aHR 1.36; 95% CI 1.10-1.68; P = 0.005). The effect of liver cirrhosis on "start-to-HCC" and "start-to-death" transitions decreased over time, particularly within 2 years. CONCLUSIONS: Diabetes mellitus increased the risk of HCC development in HCV-infected patients and the risk of all-cause mortality in patients with or without HCC.
BACKGROUND AND AIM: The effect of diabetes mellitus (DM) on the development of hepatocellular carcinoma (HCC) and all-cause mortality after HCC development in chronic hepatitis C virus (HCV)-infectedpatients remains inconclusive. This cohort study aimed to investigate these issues using the Taiwanese National Health Insurance Research Database. METHODS: We retrieved and enrolled newly diagnosed DMpatients with HCV from the Longitudinal Cohort of DiabetesPatients database. Propensity score matching-including age, sex, alcohol-related liver disease, and baseline liver cirrhosis-was used to identify and enroll HCVpatients without DM from the Longitudinal Health Insurance Database (n = 1686). A multi-state model was used to investigate transitions from "start-to-HCC," "start-to-death," and "HCC-to-death." RESULTS: The multi-state model showed higher cumulative hazards for "start-to-HCC," "start-to-death," and "HCC-to-death" transitions in the DM (vs non-DM) cohort. The cumulative probability of death with or without HCC after 10 years of follow-up was higher in the DM cohort than in the non-DM cohort. Multivariable transition-specific Cox models demonstrated that DM significantly increased the risk for transition from "start-to-HCC" (adjusted hazard ratio [aHR] 1.36; 95% confidence interval [CI] 1.16-1.59; P < 0.001), "start-to-death" (aHR 2.61; 95% CI: 2.05-3.33; P < 0.001), and "HCC-to-death" (aHR 1.36; 95% CI 1.10-1.68; P = 0.005). The effect of liver cirrhosis on "start-to-HCC" and "start-to-death" transitions decreased over time, particularly within 2 years. CONCLUSIONS:Diabetes mellitus increased the risk of HCC development in HCV-infectedpatients and the risk of all-cause mortality in patients with or without HCC.
Authors: C Tebé; D Martínez-Laguna; C Carbonell-Abella; C Reyes; V Moreno; A Diez-Perez; G S Collins; D Prieto-Alhambra Journal: Osteoporos Int Date: 2019-08-23 Impact factor: 4.507
Authors: Moustafa Nouh Elemeery; Marwa Anwar Mohamed; Marwa Ahmed Madkour; Mohammed Mohammed Shamseya; Noha Mahmoud Issa; Ahmed Noah Badr; Doaa Ahmed Ghareeb; Cheol-Ho Pan Journal: World J Gastroenterol Date: 2019-11-14 Impact factor: 5.742