Does diabetes increase the risk of hepatocellular carcinoma after hepatitis B surface antigen (HBsAg) seroclearance? A territory-wide study of 4,568 patients
Refereed conference paper presented and published in conference proceedings



摘要Background: In patients with chronic hepatitis B (CHB), the presence of diabetes mellitus (DM) is associated with a 2two‐fold increase in the risk of hepatocellular carcinoma (HCC). This territory‐wide study evaluated the risk of HCC after hepatitis B surface antigen (HBsAg) seroclearance and the impact of DM on HCC development. Methods: All CHB patients who have cleared HBsAg from January 2000 to August 2016 were retrieved from Hospital Authority, Hong Kong. The age at HBsAg seroclearance, gender, diagnosis codes of DM, medication, and subsequent development of HCC were captured and analyzed. The presence of DM was defined by the diagnosis codes and/or any exposure to anti‐diabetic agents. Results: A total of 4,568 patients with HBsAg seroclearance were identified. At a median (interquartile range) follow‐up of 3.4 (1.5–5.0) years, 54 patients developed HCC; the cumulative incidence of HCC at 1, 3, and 5 years were 0.9% (95% confidence interval [CI] 0.6%–1.2%), 1.3% (1.0%–1.7%), and 1.5% (1.1%–1.9%), respectively. Among 1,221 patients (26.7%) with DM, 22 (1.8%) developed HCC; the 5‐year cumulative incidence of HCC in patients with and without DM were 2.5% (95% CI 1.6%–3.9%) and 1.1% (0.8%–1.6%), respectively (log‐rank test, P = 0.012) (hazard ratio [HR] 1.98, 95% CI 1.15–3.41; P = 0.014). In the subgroup of patients with DM, the use of statins (HR 0.36, 95% CI 0.15–0.89; P = 0.026), but not metformin (HR 1.30, 95% CI 0.44–3.84; P = 0.635), was associated with a reduced risk of HCC development. Conclusion: The risk of HCC may still persist in CHB patients who achieved HBsAg seroclearance, with the presence of DM as a risk factor. The use of statins among patients with DM is associated with a lower risk of HCC development.
著者Terry Cheuk-Fung Yip, Henry Lik‐Yuen Chan, Vincent Wai‐Sun Wong, Yee‐Kit Tse, Grace Lai‐Hung Wong
會議名稱Asian Pacific Digestive Week (APDW) 2017
會議地點Hong Kong Convention and Exhibition Centre
會議論文集題名Journal of Gastroenterology and Hepatology
期次Suppl 3
頁次189 - 189
Web of Science 學科類別Gastroenterology & Hepatology;Gastroenterology & Hepatology

上次更新時間 2020-05-08 於 06:01