Source: Clin Gastroenterol Hepatol | Posted 6 days agoEffects of Diabetes and Glycemia Control on Risk of Hepatocellular Carcinoma After Seroclearance of Hepatitis B Surface Antigen
BACKGROUND & AIMS Diabetes is associated with a 2-fold increase in risk of hepatocellular carcinoma (HCC) among patients with chronic hepatitis B virus (HBV) infection. However, we know little about the effect of diabetes on HCC risk after seroclearance of hepatitis B surface antigen (HBsAg). We evaluated the effect of diabetes and glycemic control on HCC development after HBsAg seroclearance in a population-wide study in Hong Kong.
METHODS We performed a retrospective study of 4568 patients with chronic HBV infection who cleared HBsAg from January 2000 through August 2016, using the Clinical Data Analysis and Reporting System of the Hospital Authority, Hong Kong. We collected and analyzed data on patient demographics, comorbidities, medications, laboratory test results, and subsequent development of HCC. The presence of diabetes was defined by International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code, with level of hemoglobin; A1c (HbA1c) above 6.5%, fasting glucose level of 7 mmol/L or more, and/or treatment with; any anti-diabetic agent.
RESULTS We identified 1560 patients with diabetes; 29 patients (1.9%) developed HCC after a median follow-up time of 3.4 years (interquartile range, 1.5-5.0 years). Diabetes was associated with increased risk of HCC after adjustment of age, sex, presence of cirrhosis, and the use of medications (adjusted hazard ratio, 1.85; 95% CI 1.04-3.28; P=.036). Among patients with diabetes, time-weighted average level of HbA1c was an independent risk factor for HCC, after adjustment for age at clearance, use of statins, and other important covariates (adjusted hazard ratio, 1.51, 95% CI 1.20-1.91; P<.001). A time-weighted average level of HbA1c of 7% or more was associated with a higher 5-year cumulative incidence of HCC (4.0%) than a time-weighted average HbA1c level below 7% (1.8%) (log-rank test P=.035).
CONCLUSIONS In a population-based analysis of patients with chronic HBV infection in Hong Kong, we found diabetes to be an independent risk factor for HCC after HBsAg seroclearance. However, glycemia control appears to reduce the risk of HCC. 作者: StephenW 时间: 2017-12-27 12:16
结果我们确定了1560例糖尿病患者;中位随访时间3。4年（四分位间距，1.5〜5。0年）29例（1.9％）发生HCC。调整年龄，性别，肝硬化和使用药物后，糖尿病与HCC风险增加有关（校正危险比1.85; 95％CI 1.04-3.28; P = 0.036）。在糖尿病患者中，HbA1c时间加权平均水平是调整年龄，使用他汀类药物和其他重要协变量后调整HCC的独立危险因素（校正危险比1.51,95％CI 1.20-1.91; P <0.001）。时间加权平均HbA1c水平为7％或更高与5年累积HCC发生率（4.0％）相比，时间加权平均HbA1c水平低于7％（1.8％）（log-rank test P = 0.035）。
A hemoglobin test measures the amount of hemoglobin in your blood. Hemoglobin is a protein in your red blood cells that carries oxygen to your body's organs and tissues and transports carbon dioxide from your organs and tissues back to your lungs.
血红蛋白检测可以测量血液中血红蛋白的含量。 血红蛋白是红血球中的一种蛋白质，它携带氧气到人体的器官和组织，并将二氧化碳从器官和组织传输回到肺部.
Hemoglobin, or Hb, is usually expressed in grams per deciliter (g / dL) of blood. A low level of hemoglobin in the blood contains directly to a low level of oxygen. In the United States, anemia is diagnosed if a blood test finds less than 13.5 g / dL in a man or less than 12 g / dL in a woman.Jun 23, 2017.
血红蛋白或血红蛋白通常以克每分升（g / dL）的血液表示。 血液中低水平的血红蛋白直接含有低水平的氧气。 在美国，如果一名男子的血液检测结果低于13.5克/分升或女性低于12克/分升，则诊断为贫血。2017年6月23日作者: 宽心丸 时间: 2017-12-28 23:48