Diabetes Is Associated With Increased Risk of Hepatocellular Carcinoma in Patients With Cirrhosis From Nonalcoholic Fatty Liver Disease
Diabetes increases the risk of liver disease progression and cirrhosis development in patients with nonalcoholic steatohepatitis (NASH). The association between diabetes and the risk of hepatocellular carcinoma (HCC) in NASH patients with cirrhosis is not well quantified. All patients with the diagn...
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| Veröffentlicht in: | Hepatology (Baltimore, Md.) Md.), 2020-03, Vol.71 (3), p.907-916 |
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| container_title | Hepatology (Baltimore, Md.) |
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| creator | Yang, Ju Dong Ahmed, Fowsiyo Mara, Kristin C. Addissie, Benyam D. Allen, Alina M. Gores, Gregory J. Roberts, Lewis R. |
| description | Diabetes increases the risk of liver disease progression and cirrhosis development in patients with nonalcoholic steatohepatitis (NASH). The association between diabetes and the risk of hepatocellular carcinoma (HCC) in NASH patients with cirrhosis is not well quantified. All patients with the diagnosis of NASH cirrhosis seen at Mayo Clinic Rochester between January 2006 and December 2015 were identified. All adult liver transplant registrants with NASH between 2004 and 2017 were identified using the United Network for Organ Sharing (UNOS)/Organ Procurement and Transplantation registry for external validation. Cox proportional hazard analysis was performed to investigate the association between diabetes and HCC risk. Among 354 Mayo Clinic patients with NASH cirrhosis, 253 (71%) had diabetes and 145 (41%) were male. Mean age at cirrhosis evaluation was 62. During a median follow‐up of 47 months, 30 patients developed HCC. Diabetes was associated with an increased risk of developing HCC in univariate (hazard ratio [HR] = 3.6; 95% confidence interval [CI] = 1.1‐11.9; P = 0.04) and multivariable analysis (HR = 4.2; 95% CI = 1.2‐14.2; P = 0.02). In addition, age (per decade, HR = 1.8; 95% CI = 1.2‐2.6; P |
| doi_str_mv | 10.1002/hep.30858 |
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| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2258733317</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2380550765</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3888-d424bd1394238899833bbb110683b612ac911e3b0a26009bd119c8cc835a80e3</originalsourceid><addsrcrecordid>eNp10UFr2zAYBmBRNtas26F_oAh6WQ9uP0mxLR9L0iyBsJVR2NHIyhei1rZSffJGfsH-dpW522GwkxA8esXLy9i5gGsBIG92uL9WoHN9wiYil2WmVA5v2ARkCVklVHXK3hM9AkA1lfodO1VCQVWAnLBfc2cajEh8RfyWyFtnIm74dxd3fNXbgIbS9ZujJ-63fIl7E73Fth1aE_jMBOt63xnuen5vosM-0vh25kLYeXLEF8F3_IvvTWv9zrfO8oWJ8cDX7gcGPnd0_OIDe7s1LeHH1_OMPSzuHmbLbP3182p2u86s0lpnm6mcNpvUaCrTvaq0Uk3TCAGFVk0hpLGVEKgaMLJIbRMVldXWapUbDajO2Kcxdh_884AU687RsY7p0Q9US5nrUiklykQv_6GPfgipRVJKQ55DWeRJXY3KBk8UcFvvg-tMONQC6uM4dRqn_j1OsheviUPT4eav_LNGAjcj-OlaPPw_qV7e3Y-RLxlEmAg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2380550765</pqid></control><display><type>article</type><title>Diabetes Is Associated With Increased Risk of Hepatocellular Carcinoma in Patients With Cirrhosis From Nonalcoholic Fatty Liver Disease</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Yang, Ju Dong ; Ahmed, Fowsiyo ; Mara, Kristin C. ; Addissie, Benyam D. ; Allen, Alina M. ; Gores, Gregory J. ; Roberts, Lewis R.</creator><creatorcontrib>Yang, Ju Dong ; Ahmed, Fowsiyo ; Mara, Kristin C. ; Addissie, Benyam D. ; Allen, Alina M. ; Gores, Gregory J. ; Roberts, Lewis R.</creatorcontrib><description>Diabetes increases the risk of liver disease progression and cirrhosis development in patients with nonalcoholic steatohepatitis (NASH). The association between diabetes and the risk of hepatocellular carcinoma (HCC) in NASH patients with cirrhosis is not well quantified. All patients with the diagnosis of NASH cirrhosis seen at Mayo Clinic Rochester between January 2006 and December 2015 were identified. All adult liver transplant registrants with NASH between 2004 and 2017 were identified using the United Network for Organ Sharing (UNOS)/Organ Procurement and Transplantation registry for external validation. Cox proportional hazard analysis was performed to investigate the association between diabetes and HCC risk. Among 354 Mayo Clinic patients with NASH cirrhosis, 253 (71%) had diabetes and 145 (41%) were male. Mean age at cirrhosis evaluation was 62. During a median follow‐up of 47 months, 30 patients developed HCC. Diabetes was associated with an increased risk of developing HCC in univariate (hazard ratio [HR] = 3.6; 95% confidence interval [CI] = 1.1‐11.9; P = 0.04) and multivariable analysis (HR = 4.2; 95% CI = 1.2‐14.2; P = 0.02). In addition, age (per decade, HR = 1.8; 95% CI = 1.2‐2.6; P < 0.01) and low serum albumin (HR = 2.1; 95% CI = 1.5‐2.9; P < 0.01) were significantly associated with an increased risk of developing HCC in multivariable analysis. Other metabolic risk factors, including body mass index, hyperlipidemia, and hypertension, were not associated with HCC risk. Among UNOS NASH registrants (N = 6,630), 58% had diabetes. Diabetes was associated with an increased risk of developing HCC in univariate (HR = 1.4; 95% CI = 1.1‐1.8; P < 0.01) and multivariable (HR = 1.3; 95% CI = 1.0‐1.7; P = 0.03) analysis. Conclusion: Diabetes is associated with an increased risk of HCC in patients with NASH cirrhosis.</description><identifier>ISSN: 0270-9139</identifier><identifier>EISSN: 1527-3350</identifier><identifier>DOI: 10.1002/hep.30858</identifier><identifier>PMID: 31309602</identifier><language>eng</language><publisher>United States: Wolters Kluwer Health, Inc</publisher><subject>Adult ; Age Factors ; Aged ; Body mass index ; Carcinoma, Hepatocellular - epidemiology ; Carcinoma, Hepatocellular - etiology ; Cirrhosis ; Diabetes ; Diabetes Complications - etiology ; Diabetes mellitus ; Fatty liver ; Female ; Hepatocellular carcinoma ; Hepatology ; Humans ; Hyperlipidemia ; Liver cancer ; Liver cirrhosis ; Liver Cirrhosis - complications ; Liver diseases ; Liver Neoplasms - epidemiology ; Liver Neoplasms - etiology ; Liver transplantation ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease - complications ; Registries ; Risk ; Risk factors ; Serum Albumin - analysis ; Transplants & implants</subject><ispartof>Hepatology (Baltimore, Md.), 2020-03, Vol.71 (3), p.907-916</ispartof><rights>2019 by the American Association for the Study of Liver Diseases.</rights><rights>2020 by the American Association for the Study of Liver Diseases.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3888-d424bd1394238899833bbb110683b612ac911e3b0a26009bd119c8cc835a80e3</citedby><cites>FETCH-LOGICAL-c3888-d424bd1394238899833bbb110683b612ac911e3b0a26009bd119c8cc835a80e3</cites><orcidid>0000-0002-8393-8410</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fhep.30858$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fhep.30858$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,778,782,1414,27907,27908,45557,45558</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31309602$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yang, Ju Dong</creatorcontrib><creatorcontrib>Ahmed, Fowsiyo</creatorcontrib><creatorcontrib>Mara, Kristin C.</creatorcontrib><creatorcontrib>Addissie, Benyam D.</creatorcontrib><creatorcontrib>Allen, Alina M.</creatorcontrib><creatorcontrib>Gores, Gregory J.</creatorcontrib><creatorcontrib>Roberts, Lewis R.</creatorcontrib><title>Diabetes Is Associated With Increased Risk of Hepatocellular Carcinoma in Patients With Cirrhosis From Nonalcoholic Fatty Liver Disease</title><title>Hepatology (Baltimore, Md.)</title><addtitle>Hepatology</addtitle><description>Diabetes increases the risk of liver disease progression and cirrhosis development in patients with nonalcoholic steatohepatitis (NASH). The association between diabetes and the risk of hepatocellular carcinoma (HCC) in NASH patients with cirrhosis is not well quantified. All patients with the diagnosis of NASH cirrhosis seen at Mayo Clinic Rochester between January 2006 and December 2015 were identified. All adult liver transplant registrants with NASH between 2004 and 2017 were identified using the United Network for Organ Sharing (UNOS)/Organ Procurement and Transplantation registry for external validation. Cox proportional hazard analysis was performed to investigate the association between diabetes and HCC risk. Among 354 Mayo Clinic patients with NASH cirrhosis, 253 (71%) had diabetes and 145 (41%) were male. Mean age at cirrhosis evaluation was 62. During a median follow‐up of 47 months, 30 patients developed HCC. Diabetes was associated with an increased risk of developing HCC in univariate (hazard ratio [HR] = 3.6; 95% confidence interval [CI] = 1.1‐11.9; P = 0.04) and multivariable analysis (HR = 4.2; 95% CI = 1.2‐14.2; P = 0.02). In addition, age (per decade, HR = 1.8; 95% CI = 1.2‐2.6; P < 0.01) and low serum albumin (HR = 2.1; 95% CI = 1.5‐2.9; P < 0.01) were significantly associated with an increased risk of developing HCC in multivariable analysis. Other metabolic risk factors, including body mass index, hyperlipidemia, and hypertension, were not associated with HCC risk. Among UNOS NASH registrants (N = 6,630), 58% had diabetes. Diabetes was associated with an increased risk of developing HCC in univariate (HR = 1.4; 95% CI = 1.1‐1.8; P < 0.01) and multivariable (HR = 1.3; 95% CI = 1.0‐1.7; P = 0.03) analysis. Conclusion: Diabetes is associated with an increased risk of HCC in patients with NASH cirrhosis.</description><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Body mass index</subject><subject>Carcinoma, Hepatocellular - epidemiology</subject><subject>Carcinoma, Hepatocellular - etiology</subject><subject>Cirrhosis</subject><subject>Diabetes</subject><subject>Diabetes Complications - etiology</subject><subject>Diabetes mellitus</subject><subject>Fatty liver</subject><subject>Female</subject><subject>Hepatocellular carcinoma</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Hyperlipidemia</subject><subject>Liver cancer</subject><subject>Liver cirrhosis</subject><subject>Liver Cirrhosis - complications</subject><subject>Liver diseases</subject><subject>Liver Neoplasms - epidemiology</subject><subject>Liver Neoplasms - etiology</subject><subject>Liver transplantation</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Non-alcoholic Fatty Liver Disease - complications</subject><subject>Registries</subject><subject>Risk</subject><subject>Risk factors</subject><subject>Serum Albumin - analysis</subject><subject>Transplants & implants</subject><issn>0270-9139</issn><issn>1527-3350</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10UFr2zAYBmBRNtas26F_oAh6WQ9uP0mxLR9L0iyBsJVR2NHIyhei1rZSffJGfsH-dpW522GwkxA8esXLy9i5gGsBIG92uL9WoHN9wiYil2WmVA5v2ARkCVklVHXK3hM9AkA1lfodO1VCQVWAnLBfc2cajEh8RfyWyFtnIm74dxd3fNXbgIbS9ZujJ-63fIl7E73Fth1aE_jMBOt63xnuen5vosM-0vh25kLYeXLEF8F3_IvvTWv9zrfO8oWJ8cDX7gcGPnd0_OIDe7s1LeHH1_OMPSzuHmbLbP3182p2u86s0lpnm6mcNpvUaCrTvaq0Uk3TCAGFVk0hpLGVEKgaMLJIbRMVldXWapUbDajO2Kcxdh_884AU687RsY7p0Q9US5nrUiklykQv_6GPfgipRVJKQ55DWeRJXY3KBk8UcFvvg-tMONQC6uM4dRqn_j1OsheviUPT4eav_LNGAjcj-OlaPPw_qV7e3Y-RLxlEmAg</recordid><startdate>202003</startdate><enddate>202003</enddate><creator>Yang, Ju Dong</creator><creator>Ahmed, Fowsiyo</creator><creator>Mara, Kristin C.</creator><creator>Addissie, Benyam D.</creator><creator>Allen, Alina M.</creator><creator>Gores, Gregory J.</creator><creator>Roberts, Lewis R.</creator><general>Wolters Kluwer Health, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TM</scope><scope>7TO</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8393-8410</orcidid></search><sort><creationdate>202003</creationdate><title>Diabetes Is Associated With Increased Risk of Hepatocellular Carcinoma in Patients With Cirrhosis From Nonalcoholic Fatty Liver Disease</title><author>Yang, Ju Dong ; Ahmed, Fowsiyo ; Mara, Kristin C. ; Addissie, Benyam D. ; Allen, Alina M. ; Gores, Gregory J. ; Roberts, Lewis R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3888-d424bd1394238899833bbb110683b612ac911e3b0a26009bd119c8cc835a80e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Body mass index</topic><topic>Carcinoma, Hepatocellular - epidemiology</topic><topic>Carcinoma, Hepatocellular - etiology</topic><topic>Cirrhosis</topic><topic>Diabetes</topic><topic>Diabetes Complications - etiology</topic><topic>Diabetes mellitus</topic><topic>Fatty liver</topic><topic>Female</topic><topic>Hepatocellular carcinoma</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Hyperlipidemia</topic><topic>Liver cancer</topic><topic>Liver cirrhosis</topic><topic>Liver Cirrhosis - complications</topic><topic>Liver diseases</topic><topic>Liver Neoplasms - epidemiology</topic><topic>Liver Neoplasms - etiology</topic><topic>Liver transplantation</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Non-alcoholic Fatty Liver Disease - complications</topic><topic>Registries</topic><topic>Risk</topic><topic>Risk factors</topic><topic>Serum Albumin - analysis</topic><topic>Transplants & implants</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yang, Ju Dong</creatorcontrib><creatorcontrib>Ahmed, Fowsiyo</creatorcontrib><creatorcontrib>Mara, Kristin C.</creatorcontrib><creatorcontrib>Addissie, Benyam D.</creatorcontrib><creatorcontrib>Allen, Alina M.</creatorcontrib><creatorcontrib>Gores, Gregory J.</creatorcontrib><creatorcontrib>Roberts, Lewis R.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Hepatology (Baltimore, Md.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yang, Ju Dong</au><au>Ahmed, Fowsiyo</au><au>Mara, Kristin C.</au><au>Addissie, Benyam D.</au><au>Allen, Alina M.</au><au>Gores, Gregory J.</au><au>Roberts, Lewis R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diabetes Is Associated With Increased Risk of Hepatocellular Carcinoma in Patients With Cirrhosis From Nonalcoholic Fatty Liver Disease</atitle><jtitle>Hepatology (Baltimore, Md.)</jtitle><addtitle>Hepatology</addtitle><date>2020-03</date><risdate>2020</risdate><volume>71</volume><issue>3</issue><spage>907</spage><epage>916</epage><pages>907-916</pages><issn>0270-9139</issn><eissn>1527-3350</eissn><abstract>Diabetes increases the risk of liver disease progression and cirrhosis development in patients with nonalcoholic steatohepatitis (NASH). The association between diabetes and the risk of hepatocellular carcinoma (HCC) in NASH patients with cirrhosis is not well quantified. All patients with the diagnosis of NASH cirrhosis seen at Mayo Clinic Rochester between January 2006 and December 2015 were identified. All adult liver transplant registrants with NASH between 2004 and 2017 were identified using the United Network for Organ Sharing (UNOS)/Organ Procurement and Transplantation registry for external validation. Cox proportional hazard analysis was performed to investigate the association between diabetes and HCC risk. Among 354 Mayo Clinic patients with NASH cirrhosis, 253 (71%) had diabetes and 145 (41%) were male. Mean age at cirrhosis evaluation was 62. During a median follow‐up of 47 months, 30 patients developed HCC. Diabetes was associated with an increased risk of developing HCC in univariate (hazard ratio [HR] = 3.6; 95% confidence interval [CI] = 1.1‐11.9; P = 0.04) and multivariable analysis (HR = 4.2; 95% CI = 1.2‐14.2; P = 0.02). In addition, age (per decade, HR = 1.8; 95% CI = 1.2‐2.6; P < 0.01) and low serum albumin (HR = 2.1; 95% CI = 1.5‐2.9; P < 0.01) were significantly associated with an increased risk of developing HCC in multivariable analysis. Other metabolic risk factors, including body mass index, hyperlipidemia, and hypertension, were not associated with HCC risk. Among UNOS NASH registrants (N = 6,630), 58% had diabetes. Diabetes was associated with an increased risk of developing HCC in univariate (HR = 1.4; 95% CI = 1.1‐1.8; P < 0.01) and multivariable (HR = 1.3; 95% CI = 1.0‐1.7; P = 0.03) analysis. Conclusion: Diabetes is associated with an increased risk of HCC in patients with NASH cirrhosis.</abstract><cop>United States</cop><pub>Wolters Kluwer Health, Inc</pub><pmid>31309602</pmid><doi>10.1002/hep.30858</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-8393-8410</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Age Factors Aged Body mass index Carcinoma, Hepatocellular - epidemiology Carcinoma, Hepatocellular - etiology Cirrhosis Diabetes Diabetes Complications - etiology Diabetes mellitus Fatty liver Female Hepatocellular carcinoma Hepatology Humans Hyperlipidemia Liver cancer Liver cirrhosis Liver Cirrhosis - complications Liver diseases Liver Neoplasms - epidemiology Liver Neoplasms - etiology Liver transplantation Male Middle Aged Non-alcoholic Fatty Liver Disease - complications Registries Risk Risk factors Serum Albumin - analysis Transplants & implants |
| title | Diabetes Is Associated With Increased Risk of Hepatocellular Carcinoma in Patients With Cirrhosis From Nonalcoholic Fatty Liver Disease |
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