- 现金
- 62111 元
- 精华
- 26
- 帖子
- 30437
- 注册时间
- 2009-10-5
- 最后登录
- 2022-12-28
|
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.
|
|