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

BACKGROUND Type 2 diabetes mellitus(T2DM)has been shown to be correlated with hepatocellular carcinoma(HCC)development.However,further investigation is needed to understand how T2DM characteristics affect the prognosis of chronic hepatitis B(CHB)patients.AIM To assess the effect of T2DM on CHB patients with cirrhosis and to determine the risk factors for HCC development.METHODS Among the 412 CHB patients with cirrhosis enrolled in this study,there were 196with T2DM.The patients in the T2DM group were compared to the remaining 216patients without T2DM(non-T2DM group).Clinical characteristics and outcomes of the two groups were reviewed and compared.RESULTS T2DM was significantly related to hepatocarcinogenesis in this study(P=0.002).The presence of T2DM,being male,alcohol abuse status,alpha-fetoprotein>20ng/mL,and hepatitis B surface antigen>2.0 log IU/mL were identified to be risk factors for HCC development in the multivariate analysis.T2DM duration of more than 5 years and treatment with diet control or insulin±sulfonylurea significantly increased the risk of hepatocarcinogenesis.CONCLUSION T2DM and its characteristics increase the risk of HCC in CHB patients with cirrhosis.The importance of diabetic control should be emphasized for these patients.

Diabetes mellitus and hepatocellular carcinoma:Comparison of Chinese patients with and without HBV-related cirrhosis

AIM:To determine the role of diabetes mellitus(DM) and other associated factors in Chinese hepatocellular carcinoma(HCC) patients with cirrhosis,compared with those HCC patients without cirrhosis,in the single setting of hepatitis B virus(HBV) infection,after other known concomitant diseases were excluded.METHODS:A total of 482 patients,treated at the China-Japan Friendship Hospital,Ministry of Health(Beijing,China),in the period January 2003 to June 2009,and with a hospital discharge diagnosis of HCC,were included.Demographic,clinical,laboratory,metabolic and instrumental features were analyzed.RESULTS:Of the total,310 patients were diagnosed with HBV infection and,following the inclusion and exclusion criteria,224 were analyzed,including 122 patients(54.5%) with cirrhosis(the case group) and 102 patients without cirrhosis(the control group).Twentyseven patients(12.1%) were diabetic,including 19 in the case group and 8 in the control group(19/122=15.6% vs 8/102=7.8%,P=0.077).Thirty-one possible relevant parameters were compared by univariate analysis,and 9 variables were selected for multivariable analysis,including DM(P=0.077),past history of HBV infection(P=0.005),total bilirubin(P<0.001),albumin level(P<0.001),international normalized ratio(INR)(P<0.001),alanine aminotransferase(P=0.050),platelet(P<0.001),total cholesterol(P= 0.047),and LDL cholesterol(P=0.002) levels.Diabetes showed a statistical difference by multivariable analysis [odds ratio(OR) 4.88,95% confidence interval(CI):1.08-21.99,P=0.039],although no significant difference was found in univariate analysis.In addition,three cirrhosis-related parameters remained statistically different,including INR(OR 117.14,95% CI:4.19-3272.28,P=0.005),albumin(OR 0.89,95% CI:0.80-0.99,P=0.027),and platelet count(OR 0.992,95% CI:0.987-0.999,P=0.002).CONCLUSION:Besides the three cirrhosis-related parameters,DM was found to be the sole independent factor associated with HCC in patients with HBV-related cirrhosis,compared with those without cirrhosis.

Potential role of diabetes mellitus in the progression of cirrhosis to hepatocellular carcinoma:a cross-sectional case-control study from Chinese patients with HBV infection

BACKGROUND: Diabetes mellitus (DM) is regarded as a new risk factor for hepatocellular carcinoma (HCC), but few studies have focused on the potential role of DM in the progression of cirrhosis to HCC as well as in patients with simple HBV infection. METHODS: A cohort of 1028 patients, treated at our hospital and with a hospital discharge diagnosis of HCC and/or cirrhosis, was screened. Among them, 558 were diagnosed with chronic HBV infection and 370 were analyzed statistically according to the diagnostic, inclusion and exclusion criteria. The demographic, clinical, metabolic, virological, biochemical, radiological and pathological features were analyzed and the multivariate logistic regression model was used to determine the potential role of DM. RESULTS: In 248 cirrhotic patients, 76 were diabetic and their mean duration of DM was 4.6 years. In 122 HCC patients with cirrhosis, 25 were diabetic and their mean duration of DM was 4.4 years. Univariate analysis showed that compared with cirrhotic patients, the HCC patients had a higher percentage in males (P=0.001), a lower percentage in DM patients (P=0.039), a higher percentage in cigarette smokers (P=0.005), a higher percentage in patients with AFP】400 ng/mL (P【0.001), higher values of white blood cells (P【0.001), hemoglobin (P【0.001) and platelet (P【0.001), increased levels of ALT (P【0.001) and GGT (P【0.001), higher total bilirubin (P=0.018) and albumin levels (P【0.001), and a lower international normalized ratio (P【0.001). Multivariate logistic regression analysis showed that DM was anindependent associated factor for HCC [odds ratio (OR)=0.376; 95% CI, 0.175-0.807; P=0.012]. Even after the HCC patients were restricted to those with decompensated cirrhosis and compared with decompensated cirrhotic patients, the similar result was observed (OR=0.192; 95% CI, 0.054-0.679; P=0.010). CONCLUSIONS: DM is an independent factor in the progression of cirrhosis to HCC, but the role may be contrary to our current viewpoint. To clarify the causal relationship of DM and HCC, prospective and experimental studies are required.

Association of Overt Diabetes Mellitus with the Non-CC but not the CC Genotype of Interleukin-28B in Hepatitis C Virus Infected Patients

Background:Interleukin-28B (IL-28B) polymorphism is an important predictor for hepatitis C virus (HCV) treatment response.Whether IL-28b genotypes also influence other nontreatment related clinical parameters is unclear.Methods:Patients with HCV-related chronic liver diseases who attended our department during 2012-2014 were retrospectively analyzed.The single nucleotide polymorphisms (SNPs) of rs12979860 (IL-28B) were correlated with various clinical parameters.We also compared these parameters in patients with and without overt diabetes to identify possible associations.Results:A total of 115 patients were included (median age 48,range 15-76 years;70% males).Overall,43/115(37%) patients had chronic hepatitis,while the remaining 72/115 (63%) had cirrhosis.The most common IL-28B genotype was CC,which was found in 53% of patients (61/115),while the remaining 47% were nonCC [CT 42% (48/115) and T-r 5% (6/115)].Clinical and laboratory parameters like Hb,white blood cell (WBC),platelets,bilirubin,transaminases,and albumin were similar in the CC and nonCC genotypes.Overt diabetes mellitus was present in 22% (25/115) of patients.Patients with nonCC genotype had significantly higher prevalence of overt diabetes mellitus than patients with CC genotype (31% [17/54] versus 13% [8/61];p < 0.05).When parameters were compared in patients with and without overt diabetes mellitus,only IL-28B and age were significantly associated with overt diabetes mellitus (p < 0.05).Conclusion:In HCV patients,overt diabetes mellitus was more commonly associated with the nonCC genotype of IL-28B than the CC genotype.Carriers of the T-allele of SNP rs12979860 were more likely to have insulin resistance than CC homozygotes,and this finding may explain the higher prevalence of diabetes in non-CC genotypes.Thus,an IL-28B test may be useful in patients of HCV in order to determine their likelihood of developing diabetes mellitus.

Effect of Telbivudine tablet combined Jianpi Bushen recipe on HBV specific cytotoxic T lymphocyte and HBe Ag seroconversion in patients with HBe Ag positive chronic hepatitis B

Objective To explore the effect of Telbivudine(LDT)Tablet combined with Jianpi Bushen Recipe(JBR)on serum hepatitis B virus(HBV)specific cytotoxic T lymphocyte(CTL)and HBe Ag seroconversion in chronic hepatitis B(CHB)patients.Methods Totally90 HBe Ag-positive and human leukocyte antigen(HLA)-A2 positive CHB patients were randomly assigned to

慢性HBV感染与妊娠期糖尿病关系的Meta分析

目的探讨慢性乙型肝炎病毒(HBV)感染是否为妊娠期糖尿病(GDM)的危险因素。方法通过PubMed、Web of Science、中国知网、万方、维普数据库搜索2009年1月1日到2014年12月31日期间发表,筛选研究类型为回顾性队列研究或者病例对照研究的相关文献,共搜索出477篇,最终有10篇文献符合纳入标准,总样本量为413 150例。敏感性分析用一种循序算法降低异质性,之后的Me协分析采用随机效应模型。结果对10篇文献进行了Meta分析,经异质性检验,各研究间存在统计学异质性(x^2=30.07,df=9,P=0.0004,I^2=70%)。为降低异质性,删除2篇文献后,其余8篇具有较高的同质性(x^2=13.69,df=7,P=0.06,I^2=49%)。8篇文献Meta分析结果显示:慢性HBV感染组GDM发生率与非慢性HBV感染组比较,差异具有统计学意义(OR=1.31,95%CI:1.03~1.66,P=0.03),反映了慢性HBV感染是GDM的高危因素。按研究对象是否来自中国进行分组,结果显示:对中国人群还不能确定慢性HBV感染是否为GDM的危险因素(OR=1.10,95%CI:0.87~1.39,P=0.42),国外人群慢性HBV感染为GDM的危险因素(OR=1.60,95%CI:1.07~2.37,P=0.02)。结论慢性HBV感染是GDM的危险因素,但在中国尚不能确定慢性HBV感染是否为GDM的危险因素。

Efficacy observation of Yiguanjian decoction combined adefovir Dipivoxil tablet in treating HBeAg negative chronic viral hepatitis B active compensated liver cirrhosis patients

Objective To explore clinical efficacy of Yiguanjian Decoction(YD)combined Adefovir Dipivoxil Tablet(ADT)in treating HBe Ag negative chronic viral hepatitis B(CVHB)active compensated liver cirrhosis(LC)patients.Methods Totally 68 HBe Ag negative CVHB active compensated LC patients initially treated were assigned to the treatment group and the control group

恩替卡韦治疗HBeAg阳性慢性乙型肝炎的临床疗效分析

目的研究HBe Ag阳性慢性乙型肝炎患者中应用恩替卡韦治疗的效果,并与应用聚乙二醇干扰素α-2a联合恩替卡韦治疗的效果进行对比。方法选择2015年3月—2016年3月于该院治疗HBe Ag阳性慢性乙型肝炎的患者122例,所有患者按照抽签法进行随机分配为两组,一组为实验组患者61例,一组为参考组患者61例,两组患者一律均医院确诊为患有在HBe Ag阳性慢性乙型肝炎。实验组61例患者应用聚乙二醇干扰素α-2a联合恩替卡韦进行治疗,而参考组61例患者则单纯应用恩替卡韦进行治疗;统计分析两组患者的临床治疗效果以及生化学应答、病毒学应答、血清学应答等情况,并将统计的数据进行组间对比。结果根据对比结果显示,实验组61例患者的整体治疗效果为90.16%,高于参考组61例患者的整体治疗效果为62.30%;并且实验组61例患者的生化学应答、病毒学应答、血清学应答情况均好与参考组61例患者;两组患者的组间数据对比差异有统计学意义(P<0.05)。结论在HBe Ag阳性慢性乙型肝炎患者中应用恩替卡韦治疗具有一定的治疗效果,但是应用聚乙二醇干扰素α-2a联合恩替卡韦治疗的效果的更佳,且生化学应答、病毒学应答、血清学应答等情况也更为良好。

干扰素α-2b注射液治疗慢性乙型肝炎合并2型糖尿病临床研究

目的探讨合并2型糖尿病的慢性乙型肝炎(乙肝)患者接受干扰素抗病毒治疗的安全性和有效性。方法 54例慢性乙肝患者中,合并2型糖尿病的18例为治疗组,未合并2型糖尿病的36例为对照组。治疗组在治疗前改用胰岛素控制血糖。2组患者均给予重组人干扰素α-2b注射液5MU皮下注射,隔日1次,疗程1年。疗程结束后分别检测2组的肝功能、空腹血糖及餐后2h血糖,并于治疗后1、12、24周随访检测HBV DNA,比较2组血糖变化及抗病毒应答状况。结果治疗组接受干扰素治疗前后血糖变化差异无统计学意义。治疗组HBV DNA阴转率与对照组相比差异无统计学意义。结论在使用胰岛素进行血糖控制的情况下,合并2型糖尿病并不增加慢性乙肝患者采用干扰素进行抗病毒治疗的风险,也不降低患者对干扰素的应答。

恩替卡韦治疗乙型肝炎肝硬化伴肝源性糖尿病患者对肝纤维化指标的影响

目的观察恩替卡韦治疗肝源性糖尿病对肝纤维化指标的影响。方法选择2008年6月至2013年8月青岛市传染病医院收治的乙型肝炎肝硬化伴肝源性糖尿病患者98例,分为治疗组和对照组各49例,所有患者均给予糖尿病饮食及综合护肝、对症、支持治疗。治疗组给予恩替卡韦0.5 mg,1次/d,口服,52周后观察血清肝纤维化及Fibro Scan检测的肝硬度(LSM)值的差异。计量资料两组间比较采用t检验,计数资料组间比较采用χ2检验。结果治疗52周后治疗组血清肝纤维化的4项指标、层黏连蛋白、Ⅳ型胶原、透明质酸、Ⅲ型前胶原蛋白较对照组差异有统计学意义(t=2.71,P<0.01;t=3.53,P<0.01;t=2.34,P<0.05;t=2.28,P<0.05)。两组病毒学应答率和糖尿病控制率差异均有统计学意义(χ2值分别为12.69,7.14,P值均<0.01)。LSM值降低显著(t=3.22,P<0.01),同时肝功能指标(TBil、ALT、Alb)和空腹血糖等指标较对照组好转,差异有统计学意义(t=5.53,P<0.01;t=4.73,P<0.01;t=2.42,P<0.05;t=16.01,P<0.01)。结论恩替卡韦治疗HBV DNA阳性的乙型肝炎肝硬化伴肝源性,能有效降低其血清肝纤维化指标及LSM值,亦能有效改善HBV DNA复制、血糖、肝功能等指标,具有较好的临床效果。

2型糖尿病对乙型肝炎疫苗免疫效果的影响及对策研究

目的探讨2型糖尿病对乙肝疫苗接种免疫效果的影响及免疫对策。方法选择4个免疫预防接种中心的76例成人2型糖尿病患者(2型糖尿病组),并以70例同期接受预防接种、年龄及性别匹配的健康个体作为对照(对照组)。观察2组完成1个标准乙肝疫苗免疫接种程序后1、12、24个月的抗HBs阳转率和几何平均滴度(GMT),ELISA法检测血清γ干扰素(IFN-γ)、白介素(IL-)2、IL-4和IL-10水平。对低/无应答的2型糖尿病患者分别采用三角肌肌内注射和皮下+三角肌肌内注射两种方式,以20μg基因重组酵母疫苗进行再次免疫,观察抗HBs阳转率和GMT水平。结果 2型糖尿病组和对照组在完成1个标准乙肝疫苗接种程序后1个月,血清抗HBs阳转率分别为92.1%和98.6%(P<0.05),抗HBs GMT分别为106.78mU/ml和167.14mU/ml(P<0.01),低/无应答率分别为19.7%和7.1%。2型糖尿病组血清IFN-γ、IL-2和IL-4水平均显著低于对照组(P<0.05)。对低/无应答2型糖尿病患者于完成标准疫苗接种后第1个月采用20μg疫苗复种,皮下+三角肌肌内注射和单纯肌内注射抗HBs阳转率分别为73.3%和60.0%(P<0.05)。结论 2型糖尿病是影响成人乙肝疫苗接种免疫效果的因素之一,其机制可能与Th1/Th2细胞因子水平相对减低有关;采用皮下+三角肌肌内注射20μg重组酵母疫苗能够显著提高成人2型糖尿病患者乙肝疫苗接种成功率。

慢性丙型肝炎病毒感染者2型糖尿病流行病学调查

目的研究慢性丙型肝炎病毒感染者2型糖尿病的发病情况。方法对221例慢性丙型肝炎感染者(其中肝硬化72例)2型糖尿病发病情况进行调查,并与慢性乙型肝炎病毒感染者660例(其中肝硬化220例)2型糖尿病发病情况进行对照。结果慢性丙型肝炎感染者2型糖尿病的发病率为21.2%(47/221),高于慢性乙型肝炎感染者的10.9%(72/660)(P<0.02);丙型肝炎病毒致肝硬化2型糖尿病的发病率为30.6%(22/72),明显高于慢性丙型肝炎患者2型糖尿病发病率23.4%(35/149),(P<0.05),并明显高于对照组乙型肝炎病毒致肝硬化2型糖尿病的发病率11.3%(25/220),(P<0.05)。结论肝硬化是慢性丙型肝炎感染者发生2型糖尿病的危险因素;肝硬化和丙型肝炎病毒共同作用导致了2型糖尿病危险性的增加。丙型肝炎病毒致肝硬化2型糖尿病的发病率明显高于乙型肝炎病毒致肝硬化。

阿德福韦酯联合苦参素治疗YMDD变异慢性乙型肝炎患者的疗效

目的:观察阿德福韦酯联合苦参素对经拉米夫定治疗后出现YMDD变异的慢性乙型肝炎患者的疗效和安全性。方法:选择80例慢性乙型肝炎患者,均为拉米夫定治疗过程中出现YMDD变异,HBeAg阳性,肝功能异常者,用阿德福韦酯联合苦参素治疗12个月以上,进行HBV-DNA含量、丙氨酸氨基转移酶(ALT)、HBeAg检测以观察其疗效及安全性。结果:经阿德福韦酯联合苦参素治疗3,6,12个月后HBV-DNA阴转率分别为30.67(17例)、46.83(20例)、61.67(26例),ALT复常率为48.06(20例)、63.71(27例)、80.45(34例)。HBeAg的阴转率为15.83(7例)、27.5(12例)、34.17(14例)。患者服用12个月以上未见明显的肾毒性及耐药变异的情况。结论:阿德福韦酯、苦参素联用可显著提高对YMDD变异的慢性乙型肝炎患者的抗病毒疗效。

心理护理对慢性乙型肝炎合并糖尿病患者抑郁情绪的影响效果分析

目的:探究心理护理对慢性乙型肝炎合并糖尿病患者抑郁情绪的影响效果分析。方法:选取笔者所在医院收治的96例慢性乙型肝炎合并糖尿病患者,随机分为观察组(48例)和对照组(48例)。两组患者均实施常规的护理配合,观察组在此基础上予以心理护理干预,观察对比3个月后患者的各项指标。结果:心理护理3个月后,观察组焦虑抑郁程度、各项血糖指标、生活质量等各方面均显著优于对照组,差异有统计学意义(P<0.05)。结论:心理护理有助于改善患者的焦虑抑郁情绪,提高患者治疗依从性,延缓糖尿病的恶性进展,提高患者的生活质量,值得在临床推广应用。

慢性乙型肝炎与糖尿病的研究进展

已有研究表明慢性乙型肝炎与糖尿病密切相关,可引起血糖异常,甚至诱发糖尿病,其发生机制与胰岛素抵抗、肝功能受损、肝脂肪变、乙型肝炎病毒在胰腺复制、胰腺损伤及自身免疫反应、干扰素的应用等相关。反之,胰岛素抵抗及糖尿病亦可加速慢性乙型肝炎进展为肝纤维化及肝癌。现就慢性乙型肝炎与糖尿病关系的研究进展予以综述。

肝癌及乙肝患者近5年空腹高血糖发病状况对照研究

目的：以乙肝患者为对照，对近5年来肝细胞肝癌（HCC）空腹高血糖发病状况作对照研究。方法：HCC的男性患者468例（①HCC组，其DM先于HCC确诊者25．9％），对照人群1046例分为慢乙肝／肝硬化（②CHB／LC）组、③脂肪肝组和B超提示肝“正常”图像组（④肝“正常”组）。以常规方法进行HBV标志物、抗-HCV、空腹血糖、身体质量指数（BMI）、血压检测等。结果：HCC组中：HBV阳性者空腹血糖受损阶段（IF、G）和糖尿病（DM）发病率17．2％和17．O％；HBV阴性者抗-HCV均为阴性，其IFG和DM分别为15．4M和17．9％，两者间IFG和DM发病率无显著性差异（P〉0．05）；HCC的DM发病率与HBV相关性r=-0．007。各组中：WG发生率在各组间均相似，（P〉0．05）；DM发病率在①～④组分别为17．3%、16．7％、26．2％和9．1％，①组与②组、③组和④组相比P〉0．05、P=0．008和P=0．001。BMI均值：①组、②组和④组在23．0～23．7kg／m^2之间，显著低于③组（30．3kg／m2）；血压均值：①和②组相似，显著低于③组和④组（P〈0．005）。在各组内未显示有明显的IFG高发年龄段（P〉0．05）；DM在各组高发年龄段：①组、③组和④组均为60-69岁（26．4％、35．1％和12．2％）；②组为50-59岁（22．5％）。结论：HCC患者发生DM与HBV感染无关，与慢乙肝、肝硬化密切相关。乙肝伴脂肪肝者发生DM的风险较高，超重或肥胖为主要因素；HCC和CHB／LC患者的病情严重性可能加速了IFG阶段发展为DM的过程。

Revolutionizing the understanding of liver disease:Metabolism,function and future

The intersection between metabolic-associated steatotic liver disease(MASLD)and chronic hepatitis B virus(HBV)infection is an emerging area of research with significant implications for public health and clinical practice.Wang et al’s study highlights the complexities of managing patients with concurrent MASLD and HBV.The findings revealed that patients with concurrent MASLD-HBV exhibited more severe liver inflammation and fibrosis,whereas those with HBV alone pre-sented a better lipid profile.The growing recognition of metabolic dysfunction in liver disease,reflected in the shift from nonalcoholic liver disease to MASLD,demands updates to clinical guidelines,particularly for patients with dual etio-logies.Understanding the biological interactions between MASLD and HBV could lead to novel therapeutic approaches,emphasizing the need for personalized treatment strategies.The coexistence of MASLD and HBV presents therapeutic challenges,particularly in managing advanced fibrosis and cirrhosis,which are more likely in these patients.The aim of this editorial is to analyze the interaction between MASLD and HBV,highlight the pathophysiological mechanisms that exacerbate liver disease when both conditions coexist,and discuss the clinical implications of the findings of Wang et al.

替比夫定对慢性乙型肝炎合并糖尿病患者血清钙的影响

目的探讨慢性乙型肝炎合并2型糖尿病患者经替比夫定治疗后对血清钙(Ca)水平的影响。方法依据入组标准,将入组患者分为慢性乙型肝炎合并2型糖尿病组(CHB+DM组)35例、慢性乙型肝炎组(CHB组)48例、2型糖尿病组(DM组)32例、正常对照组30例。分别检测各组患者血清Ca水平,同时所有慢性乙型肝炎患者83例,均给予替比夫定600 mg/d口服,观察应用替比夫定治疗12周前后患者血清Ca水平的变化。结果正常对照组分别与CHB+DM组、CHB组、DM组血清Ca水平进行比较,正常对照组血清Ca水平偏高,差异有统计学意义(t分别为5.021、5.869、6.004,P<0.05);CHB+DM组与CHB组在替比夫定治疗前,2组患者血清Ca水平差异无统计学意义(t=0.735,P>0.05),经替比夫定治疗12周后,2组患者血清Ca水平均较治疗前有所升高,其中CHB+DM组血清Ca水平升高明显,与治疗前相比差异有统计学意义(t=5.274,P<0.05);分析CHB+DM组患者血清Ca水平与各项肝功能指标的相关性,血清Ca与血清白蛋白(ALB)呈正相关性(r=0.428,P<0.05)。结论替比夫定治疗慢性乙型肝炎合并2型糖尿病患者过程中,可能具备一定的改善肾脏对钙离子的重吸收功能,但具体机制尚未明确,有待进一步深入研究。

乙型肝炎肝硬化合并糖尿病时发生肝细胞癌的风险:一项随访5年的前瞻性队列研究

目的阐明乙型肝炎肝硬化(CHB-Cir)合并2型糖尿病(T2DM)时发生肝细胞癌(HCC)的风险及其协同因素。方法以2010年6月~2019年6月在南方医院肝病中心随访的CHB-Cir患者为研究对象,依性别、年龄、HBeAg状态、HBV DNA水平基本匹配后,构成CHB-Cir合并T2DM队列(观察组)和CHB-Cir无T2DM队列(对照组),半年随访1次。取已完成2年或以上随访且数据完整的病例纳入统计分析。采用Kaplan-Meier法比较两组HCC累积发生率;以Cox比例风险回归模型分析CHB-Cir合并T2DM时发生HCC的风险及其协同因素。结果纳入分析的467例研究对象平均随访时间为4.4±1.62年。观察组(n=203)和对照组(n=264)新发HCC病例分别为69例和48例,观察组HCC发病密度明显高于对照组(P<0.001)。观察组HCC累积发生率明显高于对照组(P<0.001),相对危险度为2.096(P<0.01)。调整年龄(≥40岁)、肝癌家族史、既往抗病毒治疗、胆固醇升高、低密度脂蛋白胆固醇升高等因素后,T2DM仍是CHB-Cir患者发生HCC的独立危险因素(P=0.000)。结论T2DM是HCC的独立危险因素;CHB-Cir患者合并T2DM时HCC的发生风险增加2倍左右,提示及早控制糖尿病对降低CHB-Cir患者发生HCC的风险具有重要临床意义。

慢性乙型肝炎患者糖代谢异常的研究进展

慢性乙型肝炎(CHB)是由于乙型肝炎病毒(HBV)持续感染引起的肝慢性炎症性疾病。糖代谢异常则是指机体对碳水化合物、蛋白质、脂肪等物质代谢紊乱,导致调节血糖的机制失控,最终发展成为糖尿病。大量研究证实,CHB患者在病毒感染期、肝炎后肝硬化等不同阶段均与糖代谢异常密切相关,本文就近年来相关的研究进展进行综述。