PMID- 32655232
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220415
IS  - 0973-6883 (Print)
IS  - 2213-3453 (Electronic)
IS  - 0973-6883 (Linking)
VI  - 10
IP  - 4
DP  - 2020 Jul-Aug
TI  - Diabetes and Hepatocellular Carcinoma: Incidence Trends and Impact of Liver 
      Disease Etiology.
PG  - 296-303
LID - 10.1016/j.jceh.2019.11.004 [doi]
AB  - BACKGROUND/AIMS: Hepatocellular carcinoma (HCC) remains the leading cause of 
      cancer-related death among patients with type 2 diabetes mellitus (T2DM). We 
      aimed to assess the independent role of T2DM on HCC risk among patients with 
      different liver disease etiologies. METHODS: We analyzed the United Network for 
      Organ Sharing database of all adults registered for liver transplantation (LT) 
      between February 27, 2002 and December 31, 2017. For initial analyses, patients 
      were divided into four groups: nonalcoholic steatohepatitis (NASH) and all other 
      etiologies with or without T2DM. For additional analyses, we divided them based 
      on underlying etiology. Logistic regression was used to evaluate the impact of 
      T2DM with NASH and other etiologies on HCC risk. RESULTS: Overall, 24,149 (21.6%) 
      of the listed patients had HCC. Of those, 23.9% had T2DM. When compared with 
      nondiabetics, patient with NASH and T2DM had the highest risk of HCC (odds ratio 
      [OR] 1.68; 95% confidence interval [CI] 1.52-1.86), followed by patients with 
      other etiologies and diabetes. After adjusting for other risk factors, these 
      associations remained unchanged. Registrants with T2DM and NASH, cryptogenic 
      cirrhosis, hepatitis C, and alcoholic liver disease were at higher risk of HCC 
      than those without diabetes, but in patients with chronic hepatitis B or primary 
      biliary cholangitis, diabetes did not increase the HCC risk. Between 2004 and 
      2016, the annual percentage change of HCC incidence increased for all patients 
      with NASH and hepatitis C regardless of their diabetes status. For those with 
      hepatitis B, this trend was significant only for diabetics. CONCLUSIONS: The 
      additive risk of T2DM for HCC development was highest in patients with NASH. HCC 
      risk may vary depending on the underlying etiology.
CI  - (c) 2019 Indian National Association for Study of the Liver. Published by Elsevier 
      B.V. All rights reserved.
FAU - Doycheva, Iliana
AU  - Doycheva I
AD  - Institute of Digestive Heath and Liver Diseases, Mercy Medical Center, Baltimore, 
      MD, USA.
FAU - Zhang, Talan
AU  - Zhang T
AD  - Institute of Digestive Heath and Liver Diseases, Mercy Medical Center, Baltimore, 
      MD, USA.
FAU - Amjad, Waseem
AU  - Amjad W
AD  - Institute of Digestive Heath and Liver Diseases, Mercy Medical Center, Baltimore, 
      MD, USA.
FAU - Thuluvath, Paul J
AU  - Thuluvath PJ
AD  - Institute of Digestive Heath and Liver Diseases, Mercy Medical Center, Baltimore, 
      MD, USA.
AD  - University of Maryland School of Medicine, Baltimore, MD, USA.
LA  - eng
PT  - Journal Article
DEP - 20191122
PL  - India
TA  - J Clin Exp Hepatol
JT  - Journal of clinical and experimental hepatology
JID - 101574137
PMC - PMC7335702
OTO - NOTNLM
OT  - ALD, alcoholic liver disease
OT  - APC, annual percentage change
OT  - CI, confidence interval
OT  - HBV, hepatitis B virus
OT  - HCC incidence
OT  - HCC, hepatocellular carcinoma
OT  - HCV, hepatitis C virus
OT  - LT, liver transplantation
OT  - MELD, Model for End-Stage Liver Disease
OT  - NAFLD, nonalcoholic liver disease
OT  - NASH, nonalcoholic steatohepatitis
OT  - OR, odds ratio
OT  - PBC, primary biliary cholangitis
OT  - T2DM, type 2 diabetes mellitus
OT  - UNOS
OT  - UNOS, United Network for Organ Sharing
OT  - fatty liver
OT  - liver cancer
COIS- The authors have none to declare.
EDAT- 2020/07/14 06:00
MHDA- 2020/07/14 06:01
PMCR- 2021/07/01
CRDT- 2020/07/14 06:00
PHST- 2019/07/17 00:00 [received]
PHST- 2019/11/14 00:00 [accepted]
PHST- 2020/07/14 06:00 [entrez]
PHST- 2020/07/14 06:00 [pubmed]
PHST- 2020/07/14 06:01 [medline]
PHST- 2021/07/01 00:00 [pmc-release]
AID - S0973-6883(19)30278-6 [pii]
AID - 10.1016/j.jceh.2019.11.004 [doi]
PST - ppublish
SO  - J Clin Exp Hepatol. 2020 Jul-Aug;10(4):296-303. doi: 10.1016/j.jceh.2019.11.004. 
      Epub 2019 Nov 22.