睾丸激素升高会增加患有慢性乙型肝炎和糖尿病的男性肝细

StephenW

Elevated testosterone increases risk of hepatocellular carcinoma in men with chronic hepatitis B and diabetes mellitus
Terry Cheuk‐Fung Yip
Grace Lai‐Hung Wong
Henry Lik‐Yuen Chan
Yee‐Kit Tse
Lilian Yan Liang
Vicki Wing‐Ki Hui
Hye Won Lee
Grace Chung‐Yan Lui
Alice Pik‐Shan Kong
Vincent Wai‐Sun Wong
First published: 28 April 2020
https://doi.org/10.1111/jgh.15079

Abstract
Background and Aim

Male sex is a risk factor for hepatocellular carcinoma (HCC). Diabetes mellitus (DM) is associated with a doubled risk of HCC in patients with chronic hepatitis B (CHB). We examined the relationship between serum total testosterone and HCC risk in male CHB patients with DM.
Methods

We performed a retrospective cohort study of male CHB patients with DM between 2000 and 2017 using a territory‐wide electronic health‐care database in Hong Kong. DM was defined by use of anti‐diabetic medications, hemoglobin A1c ≥ 6.5%, and/or fasting glucose ≥ 7 mmol/L in two measurements or ≥ 11.1 mmol/L in one measurement.
Results

Of 928 male CHB patients with DM, 83 (8.9%) developed HCC at a median (interquartile range) of 10.7 (6.1–14.6) years. Higher testosterone was associated with an elevated risk of HCC (adjusted hazard ratio [aHR] per 1 SD increase 1.23, 95% confidence interval [CI] 1.03–1.46, P  = 0.024). The upper tertile of testosterone (aHR 1.86, 95% CI 1.02–3.39, P  = 0.043), but not middle tertile (aHR 0.84, 95% CI 0.41–1.69 P  = 0.620), was associated with a higher risk of HCC than the lower tertile. The cumulative incidence (95% CI) of HCC at 5, 10, and 15 years was 4.4% (2.5–7.2%), 12.4% (8.7–16.7%), and 19.1% (14.2–24.5%), respectively, in patients in the upper tertile of testosterone. By subgroup analysis, the association between testosterone and HCC was stronger in patients aged ≥ 50 years and those not receiving antiviral therapy.
Conclusion

Higher serum testosterone is associated with a higher incidence of HCC in male CHB patients with DM.

StephenW

睾丸激素升高会增加患有慢性乙型肝炎和糖尿病的男性肝细胞癌的风险
叶国锋
黄丽红
陈力源
谢怡洁
丽莲彦良
惠咏琪
李慧媛
雍容Chun
爱丽丝碧山
黄文顺
首次发布：2020年4月28日
https://doi.org/10.1111/jgh.15079

抽象
背景与目标

男性是肝细胞癌（HCC）的危险因素。慢性乙型肝炎（CHB）患者的糖尿病（DM）与HCC风险增加一倍有关。我们检查了男性CHB DM患者血清总睾丸激素与HCC风险之间的关系。
方法

我们在2000年至2017年间使用香港全域电子医疗数据库对男性CHB DM DM患者进行了回顾性队列研究。 DM的定义是使用抗糖尿病药物，血红蛋白A1c≥6.5％和/或两次测量中的空腹血糖≥7 mmol / L或一次测量中的≥11.1 mmol / L。
结果

在928名男性CHB DM患者中，有83名（8.9％）发生了HCC，中位（四分位间距）为10.7（6.1-14.6）年。较高的睾丸激素与肝癌风险升高有关（每1 SD升高调整后的危险比[aHR] 1.23，95％置信区间[CI] 1.03-1.46，P = 0.024）。睾丸激素的上三分位数（aHR 1.86，95％CI 1.02–3.39，P = 0.043），而不是中三分位数（aHR 0.84，95％CI 0.41–1.69 P = 0.620）与HCC的发生风险相关下三分位。在5年，10年和15年时，HCC的累积发生率（95％CI）分别为4.4％（2.5–7.2％），12.4％（8.7–16.7％）和19.1％（14.2–24.5％）。患者处于睾丸上部三分位。通过亚组分析，年龄≥50岁的患者和未接受抗病毒治疗的患者的睾丸激素和肝癌之间的关联更强。
结论

男性CHB DM患者中较高的血清睾丸激素与HCC的发生率有关。