Correlation between type 2 diabetes mellitus and hepatocellular carcinoma: a case-control study

Xiaoli Li, Rui Lin, L. Cui, Jichang Li, Jiansheng Li
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Abstract

Objective To investigate the correlation between type 2 diabetes mellitus (T2DM) and hepatocellular carcinoma (HCC) by case-control study. Methods From January 2006 to December 2015, the data of 1 350 first diagnosis HCC patients at the First Affiliated Hospital of Zhengzhou University were collected and analyzed. The univariate and multivariate logistic regression were performed to analyze the risk factors of HCC genesis, and the risk factors were further stratified. Results The results of univariate logistic regression analysis showed that smoking and obesity were not risk factors of HCC genesis (both P>0.05). Alcoholism, hepatitis B virus (HBV) infection, hepatitis C virus (HCV) infection, T2DM, and family history of HCC were the risk factors of HCC genesis (odds ratio (OR)=2.593, 4.583, 3.732, 1.955 and 1.622, 95% confidence interval (CI) 1.883 to 3.549, 3.026 to 6.940, 2.544 to 5.367, 1.708 to 2.477 and 1.314 to 2.267, all P<0.05). The results of multivariate logistic regression analysis indicated that alcoholism, HBV infection, HCV infection, T2DM and family history of HCC were independent risk factors of HCC genesis (OR=2.034, 4.564, 2.831, 1.881 and 1.616, 95%CI 1.507 to 2.745, 2.672 to 7.765, 1.562 to 5.047, 1.314 to 2.671 and 1.177 to 2.228, all P<0.01), and T2DM could increase the risk of HCC genesis (P<0.01). In order to exclude the interference of alcoholism, HBV infection and HCV infection on above results, further stratified analysis showed that T2DM was one of the independent risk factors of HCC genesis (χ2=5.190, P=0.023), and had synergistic effect with alcoholism, HBV infection and HCV infection (χ2=32.848, P<0.01). There were significant differences in the propovtion, duration of disease and hemoglobin A1c level of T2DM patients between the case group and the control group (χ2=46.618, 81.644 and 43.092, all P<0.01). Conclusions T2DM is one of the independent risk factors or HCC genesis. T2DM is correlated with the pathogenesis of HCC. The clinical desease course and blood glucose control in patients with T2DM are also correlated with the pathogenesis of HCC. Key words: Diabetes mellitus, type 2; Carcinoma, hepatocellular; Risk factors
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2型糖尿病与肝细胞癌的相关性:一项病例对照研究
目的通过病例对照研究探讨2型糖尿病(T2DM)与肝细胞癌(HCC)的相关性。方法收集2006年1月至2015年12月郑州大学第一附属医院首次确诊HCC患者1350例资料进行分析。采用单因素和多因素logistic回归分析HCC发生的危险因素,并对危险因素进行进一步分层。结果单因素logistic回归分析结果显示,吸烟和肥胖不是HCC发生的危险因素(P>0.05)。酒精中毒、乙型肝炎病毒(HBV)感染、丙型肝炎病毒(HCV)感染、T2DM、HCC家族史是HCC发生的危险因素(优势比(OR)=2.593、4.583、3.732、1.955、1.622,95%可信区间(CI)为1.883 ~ 3.549、3.026 ~ 6.940、2.544 ~ 5.367、1.708 ~ 2.477、1.314 ~ 2.267,P均<0.05)。多因素logistic回归分析结果显示,酒精中毒、HBV感染、HCV感染、T2DM、HCC家族史是HCC发生的独立危险因素(OR=2.034、4.564、2.831、1.881、1.616,95%CI为1.507 ~ 2.745、2.672 ~ 7.765、1.562 ~ 5.047、1.314 ~ 2.671、1.177 ~ 2.228,P均<0.01),T2DM可增加HCC发生的危险(P<0.01)。为排除酒精中毒、HBV感染、HCV感染对上述结果的干扰,进一步分层分析发现T2DM是HCC发生的独立危险因素之一(χ2=5.190, P=0.023),且与酒精中毒、HBV感染、HCV感染有协同作用(χ2=32.848, P<0.01)。病例组与对照组T2DM患者比例、病程、糖化血红蛋白水平比较,差异均有统计学意义(χ2=46.618、81.644、43.092,P均<0.01)。结论T2DM是HCC发生的独立危险因素之一。T2DM与HCC的发病机制相关。T2DM患者的临床病程和血糖控制也与HCC的发病机制相关。关键词:糖尿病;2型;癌,肝细胞;风险因素
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