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糖基化血红蛋白与降糖治疗与肝细胞癌的关系探讨

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摘要 目的探讨血糖控制、降糖治疗与肝细胞癌之间的关系。方法 465例肝细胞癌、618例肝硬化、490例无肝脏疾病对照者作为研究对象,观察2型糖尿病降糖治疗、HbA1c水平与HCC的关系。结果 DM2患者中HCC比率为31.2%、肝硬化患者为23.2%、对照组为12.6%(P<0.0001)。研究对象的86%,在诊断为HCC前1年以上已经诊断为DM2。伴DM2的HCC患者肝癌危险增加1.5~2.5倍。HbA1c平均水平在HCC伴DM2患者较肝硬化患者和控制的DM2患者高。肝硬化及控制的DM2患者较HCC患者更多使用二甲双胍降糖治疗。经多变量分析显示,应用二甲双胍治疗可比磺脲药及胰岛素治疗降低HCC危险达80%左右,而磺脲药和胰岛素治疗比较无统计学意义。HbA1c水平升高与糖尿病患者HCC危险性呈正相关,HbA1c增加1%患KCC危险增加26%~50%。结论已经诊断为糖尿病患者,慢性血糖控制不良增加HCC危险性,二甲双胍治疗显著降低这种危险性。
作者 刘京
出处 《中国医药指南》 2011年第21期270-273,共4页 Guide of China Medicine
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