PMID- 33427937 OWN - NLM STAT- MEDLINE DCOM- 20211203 LR - 20230926 IS - 1435-5922 (Electronic) IS - 0944-1174 (Print) IS - 0944-1174 (Linking) VI - 56 IP - 3 DP - 2021 Mar TI - Hepatocellular carcinoma development in diabetic patients: a nationwide survey in Japan. PG - 261-273 LID - 10.1007/s00535-020-01754-z [doi] AB - BACKGROUND: Although type 2 diabetes mellitus (T2DM) is a known risk factor for hepatocellular carcinoma (HCC) development, the annual incidence in diabetes patients is far below the threshold of efficient surveillance. This study aimed to elucidate the risk factors for HCC in diabetic patients and to determine the best criteria to identify surveillance candidates. METHODS: The study included 239 patients with T2DM who were diagnosed with non-viral HCC between 2010 and 2015, with >/= 5 years of follow-up at diabetes clinics of 81 teaching hospitals in Japan before HCC diagnosis, and 3277 non-HCC T2DM patients from a prospective cohort study, as controls. Clinical data at the time of and 5 years before HCC diagnosis were collected. RESULTS: The mean patient age at HCC diagnosis was approximately 73 years, and 80% of the patients were male. The proportion of patients with insulin use increased, whereas the body mass index (BMI), proportion of patients with fatty liver, fasting glucose levels, and hemoglobin A1c (HbA1c) levels decreased significantly in 5 years. In the cohort study, 18 patients developed HCC during the mean follow-up period of 4.7 years with an annual incidence of 0.11%. Multivariate logistic regression analyses showed that the FIB-4 index was an outstanding predictor of HCC development along with male sex, presence of hypertension, lower HbA1c and albumin levels, and higher BMI and gamma-glutamyl transpeptidase levels. Receiver-operating characteristic analyses showed that a FIB-4 cut-off value of 3.61 could help identify high-risk patients, with a corresponding annual HCC incidence rate of 1.1%. CONCLUSION: A simple calculation of the FIB-4 index in diabetes clinics can be the first step toward surveillance of HCC with a non-viral etiology. FAU - Tateishi, Ryosuke AU - Tateishi R AUID- ORCID: 0000-0003-3021-2517 AD - Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. tateishi-tky@umin.ac.jp. FAU - Matsumura, Takeshi AU - Matsumura T AD - Department of Metabolic Medicine, Kumamoto University Faculty of Life Sciences, Kumamoto, Japan. FAU - Okanoue, Takeshi AU - Okanoue T AD - Department of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Suita, Japan. FAU - Shima, Toshihide AU - Shima T AD - Department of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Suita, Japan. FAU - Uchino, Koji AU - Uchino K AD - Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. FAU - Fujiwara, Naoto AU - Fujiwara N AD - Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. FAU - Senokuchi, Takafumi AU - Senokuchi T AD - Department of Metabolic Medicine, Kumamoto University Faculty of Life Sciences, Kumamoto, Japan. FAU - Kon, Kazuyoshi AU - Kon K AD - Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan. FAU - Sasako, Takayoshi AU - Sasako T AD - Department of Diabetes and Metabolic Diseases, The University of Tokyo Graduate School of Medicine, Tokyo, Japan. AD - Department of Molecular Sciences on Diabetes, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. FAU - Taniai, Makiko AU - Taniai M AD - Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Tokyo, Japan. FAU - Kawaguchi, Takumi AU - Kawaguchi T AD - Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan. FAU - Inoue, Hiroshi AU - Inoue H AD - Metabolism and Nutrition Research Unit, Kanazawa University Institute for Frontier Science Initiative, Kanazawa, Japan. FAU - Watada, Hirotaka AU - Watada H AD - Department of Medicine, Metabolism and Endocrinology, Juntendo University School of Medicine, Tokyo, Japan. FAU - Kubota, Naoto AU - Kubota N AD - Department of Diabetes and Metabolic Diseases, The University of Tokyo Graduate School of Medicine, Tokyo, Japan. FAU - Shimano, Hitoshi AU - Shimano H AD - Department of Internal Medicine, Metabolism and Endocrinology, Tsukuba University, Tsukuba, Japan. FAU - Kaneko, Shuichi AU - Kaneko S AD - Department of Gastroenterology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan. FAU - Hashimoto, Etsuko AU - Hashimoto E AD - Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Tokyo, Japan. FAU - Watanabe, Sumio AU - Watanabe S AD - Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan. FAU - Shiota, Goshi AU - Shiota G AD - Division of Molecular and Genetic Medicine, Institute of Regenerative Medicine and Biofunction, Graduate School of Medicine, Tottori University, Yonago, Japan. FAU - Ueki, Kohjiro AU - Ueki K AD - Diabetes Research Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan. FAU - Kashiwabara, Kosuke AU - Kashiwabara K AD - Department of Biostatistics, The University of Tokyo Graduate School of Medicine, Tokyo, Japan. FAU - Matsuyama, Yutaka AU - Matsuyama Y AD - Department of Biostatistics, The University of Tokyo Graduate School of Medicine, Tokyo, Japan. FAU - Tanaka, Hideo AU - Tanaka H AD - Fujiidera Public Health Center, Fujiidera, Japan. FAU - Kasuga, Masato AU - Kasuga M AD - The Institute for Adult Diseases, Asahi Life Foundation, Tokyo, Japan. FAU - Araki, Eiichi AU - Araki E AD - Department of Metabolic Medicine, Kumamoto University Faculty of Life Sciences, Kumamoto, Japan. FAU - Koike, Kazuhiko AU - Koike K AD - Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. CN - LUCID study investigators LA - eng PT - Journal Article DEP - 20210111 PL - Japan TA - J Gastroenterol JT - Journal of gastroenterology JID - 9430794 SB - IM MH - Aged MH - Carcinoma, Hepatocellular/*etiology/physiopathology MH - Cohort Studies MH - Diabetes Complications/etiology MH - Diabetes Mellitus, Type 2/epidemiology/physiopathology MH - Female MH - Humans MH - Japan/epidemiology MH - Liver Neoplasms/epidemiology/etiology/physiopathology MH - Logistic Models MH - Male MH - Middle Aged MH - ROC Curve MH - Registries/statistics & numerical data MH - Surveys and Questionnaires PMC - PMC7932951 OTO - NOTNLM OT - FIB-4 index OT - Hepatocellular carcinoma OT - Type 2 diabetes mellitus FIR - Karino, Yoshiyasu IR - Karino Y FIR - Hige, Shuhei IR - Hige S FIR - Sekiguchi, Masatomo IR - Sekiguchi M FIR - Ogawa, Koji IR - Ogawa K FIR - Miyoshi, Hideaki IR - Miyoshi H FIR - Cho, KyuYong IR - Cho K FIR - Baba, Masaru IR - Baba M FIR - Inoue, Atsushi IR - Inoue A FIR - Aso, Kazuobu IR - 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Ohta H FIR - Komura, Takuya IR - Komura T FIR - Kurita, Seiichiro IR - Kurita S FIR - Toshikuni, Nobuyuki IR - Toshikuni N FIR - Koya, Daisuke IR - Koya D FIR - Watanabe, Ai IR - Watanabe A FIR - Nakamoto, Yasunari IR - Nakamoto Y FIR - Nemoto, Tomoyuki IR - Nemoto T FIR - Konoshita, Tadashi IR - Konoshita T FIR - Kobayashi, Yoshimasa IR - Kobayashi Y FIR - Shimoyama, Shin IR - Shimoyama S FIR - Nishimura, Daisaku IR - Nishimura D FIR - Imoto, Masami IR - Imoto M FIR - Nakashima, Sayori IR - Nakashima S FIR - Mizuno, Tatsuo IR - Mizuno T FIR - Yoshioka, Kentaro IR - Yoshioka K FIR - Kawabe, Naoto IR - Kawabe N FIR - Atsushi, Suzuki IR - Atsushi S FIR - Kakita, Ayako IR - Kakita A FIR - Kojima, Yuji IR - Kojima Y FIR - Murata, Kazuya IR - Murata K FIR - Takei, Yoshiyuki IR - Takei Y FIR - Iwasa, Motoo IR - Iwasa M FIR - Yano, Yutaka IR - Yano Y FIR - Kondo, Masahiko IR - Kondo M FIR - Okamoto, Motozumi IR - Okamoto M FIR - Kimura, Hiroyuki IR - Kimura H FIR - Marusawa, Hiroyuki IR - Marusawa H FIR - 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Hiasa Y FIR - Koizumi, Yohei IR - Koizumi Y FIR - Haruhiko, Osawa IR - Haruhiko O FIR - Hadate, Toshimi IR - Hadate T FIR - Sato, Takeaki IR - Sato T FIR - Ichino, Isao IR - Ichino I FIR - Nomura, Hideyuki IR - Nomura H FIR - Yamashita, Nobuyuki IR - Yamashita N FIR - Maeno, Hiroshi IR - Maeno H FIR - Matubayashi, Sunao IR - Matubayashi S FIR - Motomura, Kenta IR - Motomura K FIR - Ishibashi, Yukie IR - Ishibashi Y FIR - Ide, Makoto IR - Ide M FIR - Moribe, Yoko IR - Moribe Y FIR - Harada, Masaru IR - Harada M FIR - Shibata, Michihiko IR - Shibata M FIR - Okada, Yosuke IR - Okada Y FIR - Torimoto, Keiichi IR - Torimoto K FIR - Torimura, Takuji IR - Torimura T FIR - Kawaguchi, Takumi IR - Kawaguchi T FIR - Tajiri, Yuji IR - Tajiri Y FIR - Higashi, Nobuhiko IR - Higashi N FIR - Nohara, Sakae IR - Nohara S FIR - Kawaguchi, Yasunori IR - Kawaguchi Y FIR - Yoshimura, Toru IR - Yoshimura T FIR - Anzai, Keizo IR - Anzai K FIR - Iwane, Shinji IR - Iwane S FIR - Nakao, Kazuhiko IR - Nakao K FIR - Taura, Naota IR - Taura N FIR - Abiru, Norio IR - Abiru N FIR - Mori, Yoshitaka IR - Mori Y FIR - Seike, Masataka IR - Seike M FIR - Endo, Mizuki IR - Endo M FIR - Kuribayashi, Tadanobu IR - Kuribayashi T EDAT- 2021/01/12 06:00 MHDA- 2021/12/15 06:00 PMCR- 2021/01/11 CRDT- 2021/01/11 12:18 PHST- 2020/07/09 00:00 [received] PHST- 2020/11/18 00:00 [accepted] PHST- 2021/01/12 06:00 [pubmed] PHST- 2021/12/15 06:00 [medline] PHST- 2021/01/11 12:18 [entrez] PHST- 2021/01/11 00:00 [pmc-release] AID - 10.1007/s00535-020-01754-z [pii] AID - 1754 [pii] AID - 10.1007/s00535-020-01754-z [doi] PST - ppublish SO - J Gastroenterol. 2021 Mar;56(3):261-273. doi: 10.1007/s00535-020-01754-z. Epub 2021 Jan 11.