Pretreatment glucose status determines HCC development in HCV patients with mild liver disease after curative antiviral therapy

Autor: Zu-Yau Lin, Chung-Feng Huang, Jee-Fu Huang, Ming-Lun Yeh, Shinn-Cherng Chen, Wan-Long Chuang, Yu-Min Ko, Kuan-Yu Chen, Chia-Yen Dai, Cing-Yi Huang, Pei-Chien Tsai, Ming-Lung Yu
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Blood Glucose
Male
medicine.medical_specialty
SVR
Carcinoma
Hepatocellular
Hepatitis C virus
Observational Study
medicine.disease_cause
Pre-DM
Gastroenterology
Antiviral Agents
Severity of Illness Index
Diabetes Complications
03 medical and health sciences
chemistry.chemical_compound
Liver disease
0302 clinical medicine
Diabetes mellitus
Internal medicine
DM
OGTT
Medicine
Humans
Prospective Studies
HCC
Prospective cohort study
treatment
business.industry
Ribavirin
Hazard ratio
Liver Neoplasms
General Medicine
Hepatitis C
Hepatitis C
Chronic
Middle Aged
medicine.disease
digestive system diseases
Endocrinology
chemistry
030220 oncology & carcinogenesis
Hepatocellular carcinoma
HCV
ComputingMethodologies_DOCUMENTANDTEXTPROCESSING
030211 gastroenterology & hepatology
Female
business
Research Article
Follow-Up Studies
Zdroj: Medicine
ISSN: 1536-5964
0025-7974
Popis: Supplemental Digital Content is available in the text
Although diabetes mellitus (DM) is known to increase the risk of hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC), the impact of dynamic glucose status on HCC occurrence in chronic hepatitis C (CHC) patients receiving antiviral therapy is unclear. In total, 1112 biopsy-proven patients treated with peginterferon/ribavirin were enrolled in this study. Both pretreatment and post-treatment glucose status, including 75 g oral glucose tolerance test (OGTT), were measured to evaluate the association between glucose status and the development of HCC. Of the 1112 patients evaluated, 93 (8.4%) developed HCC >5183.8 person-years of follow-up (annual incidence rate: 1.79%). DM only influenced the risk of developing CC in patients with mild liver disease (F0-2) and a sustained virological response (SVR) but not in other patient subpopulations. Cox-regression analysis demonstrated that the strongest factor associated with HCC in patients with mild liver disease and SVR was the presence of DM (hazard ratio [HR]/95 % confidence intervals [CI]: 3.79/1.420–10.136, P = 0.008), followed by age (HR/CI: 1.06/1.001–1.117, P = 0.046) and platelet count (HR/CI: 0.989/0.979–1.000, P = 0.05). The percentages of SVR patients with F0-2 with normoglycemia, pre-DM, sub-DM (pre-sDM), and DM before treatment were 45.3% (n = 267), 29.9% (n = 176), 15.6% (n = 92), and 9.2% (n = 54), respectively. The percentages of HCC in patients with normoglycemia, pre-sDM, and DM were 1.1%, 3.7%, and 11.1%, respectively (trend P
Databáze: OpenAIRE
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