Chronic hepatitis B infection and diabetes mellitus: a double liver trouble?

IF 4.7 4区医学 0 MEDICINE, GENERAL & INTERNAL

Minerva medica Pub Date : 2023-10-01 Epub Date: 2023-03-13 DOI:10.23736/S0026-4806.23.08428-8

Fadi Abu Baker, Yana Davidov, Areil Israel, Ilan Green, Randa Taher, Ziv Ben Ari, Saif Abu Mouch

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引用次数: 0

Abstract

Background: Concomitant Diabetes mellitus (DM) is commonly recognized in patients with chronic hepatitis B (CHB) infection, although its impact on liver-related outcomes remains controversial. We aimed to evaluate the effect of DM on the course, management and outcome of patients with CHB.

Methods: We performed a large retrospective cohort study utilizing the Leumit-Health-Service (LHS) database. We reviewed electronic reports of 692106 LHS members from different ethnicities and districts in Israel from 2000-2019 and included patients with CHB diagnosis based on ICD-9-CM codes and supportive serology results. These were divided into two cohorts of patients with CHB and DM (CHD-DM) (N.=252) and those with CHB without DM (N.=964). Clinical parameters, treatment figures and patients' outcomes were compared and multiple regression models and Cox regression analysis were performed to investigate the association between DM and cirrhosis/HCC risk in CHB patients.

Results: CHD-DM patients were significantly older (49.2±10.9 vs. 37.9±14, P<0.001), and had higher rates of obesity (BMI>30) and NAFLD (47.2% vs. 23.1%, and 27% vs. 12.6%, P<0.001, respectively). Both groups had a predominance of inactive carrier (HBeAg negative infection) state, but the HBeAg seroconversion rate was significantly lower in the CHB-DM group (25% vs. 45.7%; P<0.01). Multivariable Cox regression analysis showed that DM was independently associated with increased cirrhosis risk (HR 2.63; P=0.002). Older age, advanced fibrosis and DM were associated with HCC, but DM did not reach significance (HR 1.4; P=0.12) possibly due to the small number of HCC cases.

Conclusions: Concomitant DM in CHB patients was significantly and independently associated with cirrhosis and possibly with increased risk of HCC.

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慢性乙型肝炎感染和糖尿病:双重肝病?

背景:慢性乙型肝炎(CHB)感染患者普遍认为合并糖尿病(DM)，尽管其对肝脏相关预后的影响仍存在争议。我们的目的是评估糖尿病对慢性乙型肝炎患者病程、治疗和预后的影响。方法:我们利用Leumit-Health-Service (LHS)数据库进行了一项大型回顾性队列研究。我们回顾了2000-2019年来自以色列不同种族和地区的692106名LHS成员的电子报告，其中包括根据ICD-9-CM代码和支持性血清学结果诊断为慢性乙型肝炎的患者。这些患者被分为两组:CHB合并糖尿病患者(CHD-DM) (n =252)和CHB合并糖尿病患者(n =964)。比较CHB患者的临床参数、治疗数据和患者结局，采用多元回归模型和Cox回归分析探讨CHB患者DM与肝硬化/HCC风险的相关性。结果:CHD-DM患者的年龄(49.2±10.9比37.9±14,P30)和NAFLD(47.2%比23.1%，27%比12.6%)显著增加。结论:CHB患者合并DM与肝硬化显著独立相关，并可能与HCC风险增加相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Minerva medica 医学-医学：内科

CiteScore

6.40

自引率

6.40%

发文量

358

审稿时长

>12 weeks

期刊介绍： Minerva Medica publishes scientific papers on internal medicine. Manuscripts may be submitted in the form of editorials, original articles, review articles, case reports, special articles, letters to the Editor and guidelines. The journal aims to provide its readers with papers of the highest quality and impact through a process of careful peer review and editorial work. Duties and responsibilities of all the subjects involved in the editorial process are summarized at Publication ethics.