2型糖尿病与肝细胞肝癌发病相关性的病例对照研究  

Correlation between type 2 diabetes mellitus and hepatocellular carcinoma:a case-control study

作　　者：李晓丽[1] 林锐[2] 崔玲玲[3] 李继昌[2] 李建生[2] Li Xiaoli;Lin Rui;Cui Lingling;Li Jichang;Li Jiansheng(Department of Geriatrics,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Gastroenterology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;College of Public Health,Zhengzhou University,Zhengzhou 450001,China)

机构地区：[1]郑州大学第一附属医院老年病科,450052 [2]郑州大学第一附属医院消化内科,450052 [3]郑州大学公共卫生学院,450001

出　　处：《中华消化杂志》2019年第10期683-687,共5页Chinese Journal of Digestion

摘　　要：摘要目的初步探讨2型糖尿病与肝细胞肝癌发病的相关性。方法对郑州大学第一附属医院2006年1月至2015年12月住院的1350例初诊肝细胞肝癌患者的病历资料进行收集、整理,采用单因素和多因素logistic回归分析肝细胞肝癌发病的危险因素,并对危险因素进行分层分析。结果单因素logistic回归分析结果显示,嗜烟、肥胖不是肝细胞肝癌发病的危险因素(P均>0.05)。嗜酒、HBV感染、丙型肝炎病毒(HCV)感染、2型糖尿病和肝癌家族史是肝细胞肝癌发病的危险因素(OR=2.593、4.583、3.732、1.955、1.622,95%CI 1.883~3.549、3.026~6.940、2.544~5.367、1.708~2.477、1.314~2.267,P均<0.01)。多因素logistic回归分析显示,嗜酒、HBV感染、HCV感染、2型糖尿病和肝癌家族史是肝细胞肝癌发病的独立危险因素(OR=2.034、4.564、2.831、1.881、1.616,95%CI 1.507~2.745、2.672~7.765、1.562~5.047、1.314~2.671、1.177~2.228,P均<0.01),其中2型糖尿病可增加肝细胞肝癌的发病风险(P<0.001)。为排除嗜酒、HBV感染和HCV感染对上述结果的干扰,分层分析结果显示,2型糖尿病是肝细胞肝癌发病的独立危险因素之一(χ2=5.190,P=0.023),且与嗜酒、HBV和HCV感染之间存在协同作用(χ2=32.848,P<0.01)。病例组与对照组2型糖尿病的患者比例、病程、糖化血红蛋白水平的差异均有统计学意义(χ2=46.618、81.644、43.092,P均<0.01)。结论2型糖尿病是肝细胞肝癌发病的独立危险因素之一,2型糖尿病与肝细胞肝癌的发病相关;2型糖尿病患者病程、血糖控制水平与肝细胞肝癌发病亦相关。Objective To investigate the correlation between type 2 diabetes mellitus(T2DM)and hepatocellular carcinoma(HCC)by case-control study.Methods From January 2006 to December 2015,the data of 1350 first diagnosis HCC patients at the First Affiliated Hospital of Zhengzhou University were collected and analyzed.The univariate and multivariate logistic regression were performed to analyze the risk factors of HCC genesis,and the risk factors were further stratified.Results The results of univariate logistic regression analysis showed that smoking and obesity were not risk factors of HCC genesis(both P>0.05).Alcoholism,hepatitis B virus(HBV)infection,hepatitis C virus(HCV)infection,T2DM,and family history of HCC were the risk factors of HCC genesis(odds ratio(OR)=2.593,4.583,3.732,1.955 and 1.622,95%confidence interval(CI)1.883 to 3.549,3.026 to 6.940,2.544 to 5.367,1.708 to 2.477 and 1.314 to 2.267,all P<0.05).The results of multivariate logistic regression analysis indicated that alcoholism,HBV infection,HCV infection,T2DM and family history of HCC were independent risk factors of HCC genesis(OR=2.034,4.564,2.831,1.881 and 1.616,95%CI 1.507 to 2.745,2.672 to 7.765,1.562 to 5.047,1.314 to 2.671 and 1.177 to 2.228,all P<0.01),and T2DM could increase the risk of HCC genesis(P<0.01).In order to exclude the interference of alcoholism,HBV infection and HCV infection on above results,further stratified analysis showed that T2DM was one of the independent risk factors of HCC genesis(χ2=5.190,P=0.023),and had synergistic effect with alcoholism,HBV infection and HCV infection(χ2=32.848,P<0.01).There were significant differences in the propovtion,duration of disease and hemoglobin A1c level of T2DM patients between the case group and the control group(χ2=46.618,81.644 and 43.092,all P<0.01).Conclusions T2DM is one of the independent risk factors or HCC genesis.T2DM is correlated with the pathogenesis of HCC.The clinical desease course and blood glucose control in patients with T2DM are also correlated with the pathogenesis of

关 键 词：糖尿病 2型 癌 肝细胞 危险因素 

分 类 号：R735[医药卫生—肿瘤] R587[医药卫生—临床医学]