糖尿病与乙肝相关性肝癌的关联性调查分析

Study of correlation between diabetes mellitus （DM） and HBV-related hepatocellular carcinoma

目的探讨糖尿病与乙肝相关性肝癌的发生是否存在相关性。方法对武警总医院肝脏移植研究所2002年4月-2013年5月住院期间的1536例肝病患者进行回顾性分析，采用统计学单因素与多元逐步Logistic回归法进行相关性分析。结果1536例肝病患者中，良性肝病患者735例（47．9％），乙肝相关性肝癌患者801例（52．1％）。单因素分析显示糖尿病在乙肝相关性肝癌患者中的发病率（32．6％）明显高于良性肝病组（23．5％，P〈0．01）；COX回归多因素分析显示糖尿病（OR=I．425，P〈0．05）、HBsAg阳性（OR=3．44，P〈0．01）、年龄〉50岁（OR=3．56，P〈0．01）、BMI≥25（0R=3．59，P〈0．01）、CH≥3．38mmol／L（0R=1．96，P〈0．05）、和AFP≥400ng，ml（0R=31．01，P〈0．01）是肝癌发生的独立风险因素。结论糖尿病可能是乙肝相关性肝癌发生的风险因素之一。

Objective To analyze whether diabetes mellitus （DM） is related to the incidence of hepatitis B virus （HBV）-related Hepatocellular Carcinoma （HCC）. Methods A retrospective analysis was conducted on a total of 1,536 liver disease caseswhich the patients were admitted at Organ Transplantation Institute of the General Hospital in between June 2002and May2013.The correlation between DM and HBV-related HCC was analysis with univariate analysis and COX multivariate regression analysis. Results Amongthe 1,536 patients with liver disease, there were 735 （47.9%） patients withbenign liver disease and 801 （52.1%） patients with HBV -related HCC. On univariate analysis, the incidence of DM in HCC patients （32.6%） was higher than that in patients of benign liver disease （23.5%） （P =0.000）. On COX multivariate regression analysis, DM（OR=1.425, P 〈 0.05）, HBsAg （OR=3.44,P 〈 0.01）, age 〉50 years old （OR=3.56,P =0.000）, body mass index （BMI） ≥25 （OR=3.59,P 〈0.01）, cholesterol （CH） level H≥3.38 mmol/L （OR=1.96,P 〈0.05） and serum α-fetoprotein （AFP） level≥400 ng/mL （OR=31.01,P 〈 0.01） were all significantly independent risk factor of the incidence of HCC. Conclusion DM may he a risk factor of the incidence of HBV-related HCC.