Diabetes mellitus increases the risk of hepatocellular carcinoma in treatment-naïve chronic hepatitis C patients in China

Abstract

We investigated the link between diabetes mellitus (DM) and hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) risk in treatment-naïve chronic hepatitis C (CHC) patients in China.To examine the association between DM and HCC, we conducted a case–control study of 300 Chinese CHC patients with HCC, compared to an age- and sex-matched control group of 517 CHC patients not diagnosed with HCC.We found that DM was more prevalent in the HCC patient group (18.7%) than in the CHC-only patient group (10.8%). We conducted logistic regression analyses adjusting for demographics features and other HCC risk factors and found that DM increased the risk of HCC development nearly 2-fold [adjusted odds ratio (AOR), 95% confidence interval (95% CI), 1.80 (1.17–2.75)]. Meanwhile, the proportion of HCC patients and CHC-only patients with liver cirrhosis were 79.3% and 46.2%, respectively, yielding an AOR of 4.62 (95% CI, 3.31–6.46). Multivariate analyses comparing the risk of HCV-related HCC development in DM patients with and without liver cirrhosis revealed that the estimated AOR (95% CI) for those with liver cirrhosis was 5.60 (2.25–13.96). However, the HCC risk decreased significantly with a later age of diabetes onset (AOR [95% CI], 0.94 [0.89–0.99]).DM was associated with an increased risk for HCC development in treatment-naïve CHC patients in China. Furthermore, liver cirrhosis and an early DM diagnoses further increased the risks of HCC development in patients diagnosed with both CHC and DM.

Hepatocellular Carcinoma (HCC) in Egypt: A comprehensive overview

“…Many genome-wide association studies (GWAS) have identified many loci that affect the risk of type 2 diabetes [50,51]. There are many hypotheses [52] that explain the association between diabetes and the increased risk of HCC. Diabetes is one of the component of metabolic syndrome that may lead to non-alcoholic steatohepatitis (NASH) and consequently HCC.…”

Expert Opinion on Managing Chronic HCV Infection in Patients with Type 2 Diabetes Mellitus

“…4 HCV-associated T2DM has been shown to accelerate the clinical course of chronic HCV infection, significantly increasing the risk of fibrosis and its progression to cirrhosis, decompensation and HCC [15][16][17][18][19][20][21][22][23][24]. Multiple studies have shown a link between T2DM and the development of liver fibrosis.…”

<p>Hepatocellular Carcinoma Mechanisms Associated with Chronic HCV Infection and the Impact of Direct-Acting Antiviral Treatment</p>

“…The concomitant liver disease related to non-viral etiologies accelerates HCV-induced liver disease, cirrhosis development, and HCC. [279][280][281][282][283][284][285][286][287] Obesity is associated with metabolic syndromes such as insulin resistance, type 2 diabetes, and NAFLD. A recent study using more than 900,000 US adults showed that the risk of death related to HCC was 2-fold higher in men with BMI of 30-34.9 and 4.5 times higher with BMI greater than 35.…”

“…Diabetes with HCV infection has a 2 to 3-fold increase in HCC risk. [281][282][283][284] The researchers also showed that HCC development increased due to the combined effect of alcohol and chronic HCV infection. [285][286][287] In addition to nonviral agents, co-infection with the hepatitis B virus or human immunodeficiency virus increases the risk of HCC after HCV cure.…”