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  • 罗翠松,林云,李林涛,周敏,将星星,时军.2型糖尿病与乙型肝炎病毒相关肝癌发病关系的前瞻性队列研究[J].第二军医大学学报,2018,39(12):1407-1410    [点击复制]
  • LUO Cui-song,LIN Yun,LI Lin-tao,ZHOU Min,JIANG Xing-xing,SHI Jun.Association between type 2 diabetes mellitus and hepatitis B virus-related hepatocellular carcinoma: a prospective cohort study[J].Acad J Sec Mil Med Univ,2018,39(12):1407-1410   [点击复制]
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2型糖尿病与乙型肝炎病毒相关肝癌发病关系的前瞻性队列研究
罗翠松1,2,林云1,李林涛3,周敏3,将星星1,时军2*
0
(1. 南昌大学附属新余医院肝胆胰外科, 新余 338000;
2. 南昌大学第一附属医院肝胆胰外科, 南昌 330000;
3. 南昌大学附属新余医院感染科, 新余 338000
*通信作者)
摘要:
目的 探讨2型糖尿病与乙型肝炎病毒相关肝癌发病风险的关系。方法 研究资料来源于2010年1月新余市人民医院建立的乙型肝炎病毒感染患者随访数据库。对基线非肝癌患者按是否合并2型糖尿病进行分组:糖尿病组和非糖尿病组。采用Cox比例风险回归模型分析2型糖尿病与乙型肝炎病毒相关肝癌发病风险的关系。结果 435例研究对象共随访2 245.89年,其中新发肝癌病例68例,肝癌发病密度为30.28/千人年。合并2型糖尿病者64例(糖尿病组),非糖尿病组371例,糖尿病组和非糖尿病组分别共随访331.27年和1 914.62年,肝癌发病密度分别为51.32/千人年和26.64/千人年,两组肝癌发病密度差异有统计学意义(χ2=6.80,P<0.05)。控制年龄、职业、吸烟史和饮酒史等因素后,Cox回归多因素分析结果示,糖尿病组乙型肝炎病毒感染者的肝癌发病风险是非糖尿病组的2.13倍[95%置信区间(CI):1.18~3.87]。结论 该队列人群中,2型糖尿病和乙型肝炎病毒相关肝癌发病有关,2型糖尿病增加了乙型肝炎病毒感染患者的肝癌发病风险。
关键词:  肝肿瘤  2型糖尿病  乙型肝炎病毒  前瞻性研究  队列研究
DOI:10.16781/j.0258-879x.2018.12.1407
投稿时间:2018-04-30修订日期:2018-11-19
基金项目:国家自然科学基金(81450045),江西省卫生和计划生育委员会科研项目(20167194).
Association between type 2 diabetes mellitus and hepatitis B virus-related hepatocellular carcinoma: a prospective cohort study
LUO Cui-song1,2,LIN Yun1,LI Lin-tao3,ZHOU Min3,JIANG Xing-xing1,SHI Jun2*
(1. Department of Hepatobiliary and Pancreatic Surgery, the Affiliated Xinyu Hospital of Nanchang University, Xinyu 338000, Jiangxi, China;
2. Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital of Nanchang University, Nanchang 330000, Jiangxi, China;
3. Department of Infectious Diseases, the Affiliated Xinyu Hospital of Nanchang University, Xinyu 338000, Jiangxi, China
*Corresponding author)
Abstract:
Objective To explore the association between type 2 diabetes mellitus (T2DM) and hepatitis B virus-related hepatocellular carcinoma (HCC). Methods Research data were derived from a follow-up database of hepatitis B virus infection established by the Affiliated Xinyu Hospital of Nanchang University in 2010. The patients without baseline HCC were grouped into diabetic group or non-diabetic group according to whether or not they had T2DM. Cox proportional hazard regression model was used to analyze the association between T2DM and hepatitis B virus-related HCC. Results Of the 435 patients who were followed up for 2 245.89 years, 68 were new cases of HCC. The incidence density of HCC was 30.28 per thousand person-years. Sixty-four patients with T2DM were assigned to the diabetic group, and the other 371 patients were assigned to non-diabetic group. The follow-up time was 331.27 years and 1 914.62 years in the diabetic and non-diabetic groups, respectively, and the incidence densities of HCC were 51.32 per thousand person-years and 26.64 per thousand person-years, respectively; and the difference of the incidence densities was significant (χ2=6.80, P<0.05). After adjusting for age, career, smoking and drinking, Cox regression analysis showed that the risk of HCC in the T2DM patients with hepatitis B virus infection was 2.13 times that in the non-diabetic patients (95% confidence interval[CI] 1.18-3.87). Conclusion In this cohort, T2DM is associated with hepatitis B virus-related HCC, and T2DM increases the risk of HCC in hepatitis B virus infected patients.
Key words:  liver neoplasms  type 2 diabetes mellitus  hepatitis B virus  prospective studies  cohort studies