Type 2 diabetes mellitus characteristics affect hepatocellular carcinoma development in chronic hepatitis B patients with cirrhosis

The prognosis of patients with co-morbid diabetes and hepatitis B and strategies for improving outcome

The relationship between diabetes and hepatitis B remains unclear. We have found that there is no general correlation between the incidence of diabetes and hepatitis B, except in certain populations. Patients with co-existing diabetes and hepatitis B tend to have poorer overall prognoses, primarily evidenced by an increased risk of hepatocellular carcinoma (HCC) and all-cause mortality within this population. The optimal selection of medication for these patients should take long-term prognosis into account. To improve long-term outcomes, we recommend specific anti-diabetic medications for this group. Additionally, it is advisable to administer the hepatitis B vaccine as soon as possible following a diagnosis of diabetes in order to enhance the patient's prognosis. Increased attention from health management authorities, revisions of relevant guidelines, and advancements in educational initiatives may also improve outcomes for this demographic.

Inverse association between type 2 diabetes and hepatocellular carcinoma in East Asian populations

Aims

To investigate the potential association between type 2 diabetes (T2D) and hepatocellular carcinoma (HCC) in East Asian populations using Mendelian randomization (MR) analyses.

Methods

Bidirectional Mendelian randomization (MR) studies were conducted using summary statistics from genome-wide association studies (GWAS) related to T2D and HCC. The potential effects of confounders such as chronic hepatitis B, chronic hepatitis C, body mass index, and alcohol intake frequency were corrected using a multivariate MR study. Various MR methods, including the inverse variance weighted (IVW) approach, were used to estimate the associations between T2D and HCC. Sensitivity analysis and assessment of heterogeneity were performed to ensure the robustness of the results.

Results

In the forward MR study, the IVW approach of MR analysis suggested an inverse association between T2D and HCC, with a risk odds ratio of 0.8628 (95% confidence interval [CI], 0.7888-0.9438). Furthermore, even after adjusting for BMI, chronic hepatitis B, and alcohol intake frequency, this study still supports the inverse association between T2D and HCC. Additional MR methods provided further support for this relationship. Sensitivity analysis and assessment of heterogeneity confirmed the robustness of the results. The reverse MR analysis did not show a clear impact of genetic liability to HCC on reduced risk of T2D(OR=0.9788; 95% CI, 0.9061-1.0574).

Conclusion

This study provides evidence of an inverse association between T2D and HCC in East Asian populations using MR analysis. Further studies are warranted to validate these findings.

Presence of diabetes further heightens hepatocellular carcinoma risk in patients with hepatitis B or hepatitis C virus-related cirrhosis: A meta-analysis

Objective

Impact of diabetes mellitus on the development of hepatocellular carcinoma (HCC) remained controversial in cirrhotic patients. This meta-analysis aimed to investigate the association of diabetes and the occurrence of HCC in patients with hepatitis B or hepatitis C virus-related cirrhosis.

Methods

Two authors comprehensively searched PubMed and Embase databases until June 22, 2023, to identify studies that evaluated the association of diabetes with the occurrence of HCC in patients with hepatitis B or hepatitis C virus-related cirrhosis.

Results

Sixteen retrospective/prospective cohort studies reporting on 15 articles (5357 cirrhotic patients) were included. The prevalence of diabetes in hepatitis B and hepatitis C virus-related cirrhosis patients ranged from 4 to 46%. Diabetes was associated with higher risk of HCC (risk ratio [RR] 1.74; 95% confidence intervals [CI] 1.24-2.45) in patients with hepatitis C virus-related cirrhosis. However, no significant relationship of diabetes with the occurrence of HCC was present in studies with less than 48-month follow-up among patients with hepatitis C virus-related cirrhosis (RR 1.28; 95% CI 0.68-2.43). Moreover, diabetes also conferred an increased risk of HCC (RR 2.67; 95% CI 2.03-3.51) in patients with hepatitis B virus-related cirrhosis.

Conclusion

Presence of diabetes significantly predicted the occurrence of HCC in patients with hepatitis B or hepatitis C virus-related cirrhosis.