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01.06.2011 | Original Article—Liver, Pancreas, and Biliary Tract

Post-challenge hyperglycemia is a significant risk factor for the development of hepatocellular carcinoma in patients with chronic hepatitis C

verfasst von: Hirokazu Takahashi, Toshihiko Mizuta, Yuichiro Eguchi, Yasunori Kawaguchi, Takuya Kuwashiro, Satoshi Oeda, Hiroshi Isoda, Noriko Oza, Shinji Iwane, Kenichi Izumi, Keizou Anzai, Iwata Ozaki, Kazuma Fujimoto

Erschienen in: Journal of Gastroenterology | Ausgabe 6/2011

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Abstract

Background

Several epidemiological studies have reported that diabetes mellitus is a risk factor for hepatocellular carcinoma (HCC) in hepatitis C virus (HCV)-positive patients. However, it is unclear whether or not post-challenge hyperglycemia is a risk factor. The purpose of this study was to determine the association between post-challenge hyperglycemia and hepatocarcinogenesis in HCV-positive patients.

Methods

A total of 203 HCV-RNA-positive subjects (108 males, mean age 54.3 ± 10.8 years; 95 females, mean age 56.6 ± 10.3 years; genotype 1b/2a/2b/3a: 152/38/12/1) who underwent liver biopsy and a 75-g oral glucose tolerance test, and who were treated with interferon (IFN) were enrolled in this study. None of the subjects had been treated with antidiabetic drugs. The subjects underwent ultrasonography and/or computed tomography every 6 months after the end of the IFN therapy.

Results

Thirteen patients, including one patient who achieved a sustained viral response (SVR) with IFN, developed HCC. On multivariate analysis, male sex, age >65 years, excessive alcohol consumption, non-SVR, liver steatosis area >5% in liver specimens, and 120-min post-challenge hyperglycemia were risk factors for the development of HCC. After matching subjects for sex, age, alcohol intake, and response to the IFN therapy, advanced fibrosis stages [hazard ratio (HR) 2.8], liver steatosis (HR 5.4), and 120-min post-challenge hyperglycemia (HR 4.9) were significant risk factors for the development of HCC. Furthermore, after matching for the fibrosis stage, liver steatosis (HR 5.7) and 120-min post-challenge hyperglycemia (HR 6.9) remained as significant factors for HCC development.

Conclusion

Post-challenge hyperglycemia is an independent risk factor for HCC in HCV-positive patients.

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Titel: Post-challenge hyperglycemia is a significant risk factor for the development of hepatocellular carcinoma in patients with chronic hepatitis C
verfasst von: Hirokazu Takahashi
Toshihiko Mizuta
Yuichiro Eguchi
Yasunori Kawaguchi
Takuya Kuwashiro
Satoshi Oeda
Hiroshi Isoda
Noriko Oza
Shinji Iwane
Kenichi Izumi
Keizou Anzai
Iwata Ozaki
Kazuma Fujimoto
Publikationsdatum: 01.06.2011
Verlag: Springer Japan
Erschienen in: Journal of Gastroenterology / Ausgabe 6/2011
Print ISSN: 0944-1174
Elektronische ISSN: 1435-5922
DOI: https://doi.org/10.1007/s00535-011-0381-2

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Post-challenge hyperglycemia is a significant risk factor for the development of hepatocellular carcinoma in patients with chronic hepatitis C

Abstract

Background

Methods

Results

Conclusion

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Conclusion

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