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  

Association between type 2 diabetes mellitus and hepatitis B virus-related hepatocellular carcinoma: a prospective cohort study

作　　者：罗翠松[1,2] 林云[1] 李林涛 周敏[3] 将星星 时军[2] LUO Cui-song;LIN Yun;LI Lin-tao;ZHOU Min;JIANG Xing-xing;SHI Ju(Department of Hepatobiliary and Pancreatic Surgery,the Affiliated Xinyu Hospital of Nanchang University,Xinyu 338000, Jiangxi,China;Department of Hepatobiliary and Pancreatic Surgery,the First Affiliated Hospital of Nanchang University,Nanchang 330000, Jiangxi,China;Department of Infectious Diseases,the Affiliated Xinyu Hospital of Nanchang University,Xinyu 338000,Jiangxi,China)

机构地区：[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

出　　处：《第二军医大学学报》2018年第12期1407-1410,共4页Academic Journal of Second Military Medical University

基　　金：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)~~

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。Objective To explore the association between type 2 diabetes mellitus(T2DM)and hepatitis B virusrelated 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(χ^2=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.

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 

分 类 号：R735.7[医药卫生—肿瘤]