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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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

ARTICLE HIGHLIGHTS

Research background

Type 2 diabetes mellitus (T2DM) has been shown to be correlated with hepatocellular carcinoma (HCC) development. However, the T2DM characteristics that affect HCC are unknown.

Research motivation

T2DM affects more than 440 million individuals globally. T2DM is a leading cause of death due to renal and heart complications as well as an increased risk of multiple cancers. Understanding the correlation between T2DM and HCC will benefit these patients.

Research objectives

This study aimed to investigate the relationship between T2DM clinical characteristics and HCC development in pre-existing T2DM patients with chronic hepatitis B (CHB).

Research methods

Among 412 CHB patients enrolled in this study, there were 196 patients with T2DM. The patients were divided into the T2DM group and the non-T2DM group (n = 216). Clinical characteristics and outcomes of the two groups were compared.

Research results

T2DM was found to be significantly related to hepatocarcinogenesis in this study. In the multivariate analysis, T2DM, male sex, alcohol abuse status, alpha-fetoprotein (AFP) > 20 ng/mL, and hepatitis B surface antigen (HBsAg) > 2.0 log IU/mL were identifeid to be risk factors for HCC development. T2DM duration and therapy significantly increased the risk of hepatocarcinogenesis.

Research conclusions

T2DM was found to be related to a poor CHB prognosis. Male sex, alcohol abuse status, AFP > 20 ng/mL and HBsAg > 2.0 log IU/mL were also significantly related with poor outcomes. T2DM characteristics, including T2DM duration more than 5 years and treatment of diet control or insulin ± sulfonylurea significantly increased the risk of hepatocarcinogenesis.

Research perspectives

These findings confirmed the importance of diabetic management in CHB patients. The exact mechanism of how T2DM affects HCC development still warrants further study.