Type 2 diabetes mellitus characteristics affect hepatocellular carcinoma development in chronic hepatitis B patients with cirrhosis

doi:10.12998/wjcc.v11.i5.1009

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World Journal of Clinical Cases

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Retrospective Study

World J Clin Cases. Feb 16, 2023; 11(5): 1009-1018
Published online Feb 16, 2023. doi: 10.12998/wjcc.v11.i5.1009

Type 2 diabetes mellitus characteristics affect hepatocellular carcinoma development in chronic hepatitis B patients with cirrhosis

Man-Yu Li, Ting-Ting Li, Ke-Jian Li, Cheng Zhou

Man-Yu Li, Ke-Jian Li, Cheng Zhou, Division I of In Vitro Diagnostics for Infectious Diseases, Institute for In Vitro Diagnostics Control, National Institutes for Food and Drug Control, Beijing 100050, China

Ting-Ting Li, Department of Clinical Laboratory, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China

Author contributions: Li MY designed and performed the research and wrote the paper; Li TT designed the research and contributed to the analysis; Li KJ and Zhou C supervised the report.

Supported by the National Institutes for Food and Drug Control, No. 2022C4.

Institutional review board statement: This study was reviewed and approved by the Human Ethics Committee of the Fifth Affiliated Hospital of Zhengzhou University (KY2021031).

Informed consent statement: Patients were not required to give informed consent for the study because the analysis used anonymous clinical data that were approved by the Human Ethics Committee of the Fifth Affiliated Hospital of Zhengzhou University.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Data sharing statement: No additional data are available.

Corresponding author: Man-Yu Li, PhD, Assistant Professor, Research Assistant Professor, Division I of In Vitro Diagnostics for Infectious Diseases, Institute for In Vitro Diagnostics Control, National Institutes for Food and Drug Control, No. 2 Tiantanxili Road, Dongcheng District, Beijing 100050, China. myli226@163.com

Received: October 31, 2022
Peer-review started: October 31, 2022
First decision: November 11, 2022
Revised: November 24, 2022
Accepted: January 16, 2023
Article in press: January 16, 2023
Published online: February 16, 2023
Processing time: 106 Days and 0.2 Hours

Abstract

BACKGROUND

Type 2 diabetes mellitus (T2DM) has been shown to be correlated with hepatocellular carcinoma (HCC) development. However, further investigation is needed to understand how T2DM characteristics affect the prognosis of chronic hepatitis B (CHB) patients.

AIM

To assess the effect of T2DM on CHB patients with cirrhosis and to determine the risk factors for HCC development.

METHODS

Among the 412 CHB patients with cirrhosis enrolled in this study, there were 196 with T2DM. The patients in the T2DM group were compared to the remaining 216 patients without T2DM (non-T2DM group). Clinical characteristics and outcomes of the two groups were reviewed and compared.

RESULTS

T2DM was significantly related to hepatocarcinogenesis in this study (P = 0.002). The presence of T2DM, being male, alcohol abuse status, alpha-fetoprotein > 20 ng/mL, and hepatitis B surface antigen > 2.0 log IU/mL were identified to be risk factors for HCC development in the multivariate analysis. T2DM duration of more than 5 years and treatment with diet control or insulin ± sulfonylurea significantly increased the risk of hepatocarcinogenesis.

CONCLUSION

T2DM and its characteristics increase the risk of HCC in CHB patients with cirrhosis. The importance of diabetic control should be emphasized for these patients.

Keywords: Chronic hepatitis B; Diabetes mellitus; Hepatocellular carcinoma; Prognosis; Risk factor

Core Tip: This retrospective study assessed the risk factors for hepatocellular carcinoma (HCC) development in chronic hepatitis B (CHB) patients with type 2 diabetes mellitus (T2DM). A total of 412 CHB patients were enrolled in this study. T2DM, male sex, alcohol abuse, alpha-fetoprotein > 20 ng/mL, and hepatitis B surface antigen > 2.0 log IU/mL were identified to be risk factors for HCC development. T2DM duration and treatment were also significantly related to HCC development. Thus, T2DM and T2DM characteristics affect the prognosis of CHB patients with cirrhosis.