Type 2 diabetes mellitus increases the risk of hepatocellular carcinoma in subjects with chronic hepatitis B virus infection: a meta-analysis and systematic review - PubMed (original) (raw)

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Type 2 diabetes mellitus increases the risk of hepatocellular carcinoma in subjects with chronic hepatitis B virus infection: a meta-analysis and systematic review

Yifei Tan et al. Cancer Manag Res. 2019.

Abstract

Background: Type 2 diabetes mellitus has been proved to be a risk factor of hepatocellular carcinoma, but how diabetes affects incidence of hepatocellular carcinoma among patients with chronic hepatitis B virus infection remains controversial.

Methods: A comprehensive search of Medline and Embase was performed. Incidence of hepatocellular carcinoma in chronic hepatitis B patients was the primary outcome. Pooled HRs and 95% CIs were calculated to assess the correlation between diabetes and incidence of hepatocellular carcinoma.

Results: Five cohort studies and two case-control studies were identified, with a total of 21,842 chronic hepatitis B patients. The diabetes mellitus cohort was found to have increased incidence of hepatocellular carcinoma (pooled HR 1.77, 95% CI 1.28-2.47; fixed effect) and worse overall mortality (pooled RR 1.93, 95% CI 1.64-2.27; fixed effect) in comparison with those without diabetes. In case-control studies, hepatocellular carcinoma cases were found to have an insignificantly elevated diabetes mellitus rate in comparison with the control group.

Conclusion: Type 2 diabetes mellitus is significantly associated with increased risk of hepatocellular carcinoma among patients with chronic hepatitis B virus infection, and aggressive management of diabetes mellitus is strongly suggested.

Keywords: HBV-infected; hepatocellular carcinoma risk; type 2 diabetes mellitus.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1

Figure 1

Flow diagram showing the search strategy along with the selection and screening processes for the eligible studies. Abbreviations: DM, diabetes mellitus; HCC, hepatocellular carcinoma; HBV, hepatitis C virus.

Figure 2

Figure 2

Forest plot of meta-analysis results comparing the incidence of HCC between patients with DM and those without DM. Abbreviations: HCC, hepatocellular carcinoma; DM, diabetes mellitus.

Figure 3

Figure 3

Funnel plot of studies assessing the relationship between DM and risk of HCC. Abbreviations: DM, diabetes mellitus; HCC, hepatocellular carcinoma.

Figure 4

Figure 4

Forest plot of results comparing overall mortality between DM and non-DM subjects. Abbreviations: DM, diabetes mellitus; NDM, non-DM; M–H, Mantel–Haenszel.

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