Diabetes Development Linked to Hepatocellular Carcinoma, Mortality in Hepatitis B

Through multivariate data analyses, researchers in Taiwan found that diabetes mellitus influenced the development of hepatocellular carcinoma in patients with chronic hepatitis B.

For patients with chronic hepatitis B (CHB) virus, development of diabetes mellitus (DM) is an independent risk factor for hepatocellular carcinoma (HCC), HCC-related mortality, and all-cause mortality, according to results published in the Journal of Viral Hepatology.

The study included participants with CHB who were newly diagnosed with DM in 2000 from the Longitudinal Cohort of Diabetes Patients database (n=2966). The researchers used propensity scores matching based on age, gender, alcohol-related liver disease, and baseline liver cirrhosis to compare data from study participants with data from people with CHB without DM from the Taiwanese National Health Insurance Research Database (n=2966).

During 11 years of follow-up, HCC developed in 11.8% of participants (n=708), 12.3% (n=731) of participants had all-cause mortality, and 6.1% (n=363) of participants had HCC-related mortality.

Compared with participants without DM, participants with DM had significantly higher risk for HCC development (13.3% vs 10%; P <.001) and HCC-related mortality (7.5% vs 4.7%; P <.001). Participants with DM also had a significantly higher rate of all-cause mortality (16.9%) compared with participants without DM (8.2%; P <.001).

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Using a multivariable transition-specific Cox model, the researchers determined that DM was a significant independent risk factor for HCC development (hazard ratio [HR] 1.35; 95% CI, 1.16-1.57; P <.001). They also found that DM was significantly, independently associated with HCC-related mortality (HR, 1.31; 95% CI, 1.06-1.62; P =.014) and all-cause mortality (HR, 2.32; 95% CI, 1.84-2.92; P <.001).

“These findings provide new support for adopting aggressive therapy for HCC and strict DM control for such patients,” the researchers wrote.


Shyu Y, Huang T, Chien C, Yeh C, Lin C, Chien R. Diabetes poses a higher risk of hepatocellular carcinoma and mortality in patients with chronic hepatitis B: a population-based cohort study [published online February 9, 2019]. J Viral Hepat. doi: 10.1111/jvh.13077