Hereditary hemochromatosis:Temporal trends,sociodemographic characteristics,and independent risk factor of hepatocellular cancer–nationwide population-based study  

作　　者：Maryam Bilal Haider Ali Al Sbihi Ahmed Jamal Chaudhary Syed M Haider Ahmed Iqbal Edhi 

机构地区：[1]Department of Internal Medicine,Detroit Medical Center,Wayne State University,Sinai Grace Hospital,Detroit,MI 48235,United States [2]System Science,Binghamton University,Binghamton,NY 13902,United States [3]Department of Gastroenterology,William Beaumont Hospital,Royal Oak,MI 48073,United States

出　　处：《World Journal of Hepatology》2022年第9期1804-1816,共13页世界肝病学杂志（英文版）（电子版）

摘　　要：BACKGROUND Hereditary hemochromatosis(HH)has an increased risk of hepatocellular cancer(HCC)both due to genetic risks and iron overload as iron overload can be carcinogenic;HH impacts the increasing risk of HCC,not only through the development of cirrhosis but concerning hepatic iron deposition,which has been studied further recently.AIM To evaluate HH yearly trends,patient demographics,symptoms,comorbidities,and hospital outcomes.The secondary aim sheds light on the risk of iron overload for developing HCC in HH patients,independent of liver cirrhosis complications.The study investigated HH(without cirrhosis)as an independent risk factor for HCC.METHODS We analyzed data from National Inpatient Sample(NIS)Database,the largest national inpatient data collection in the United States,and selected HH and HCC cohorts.HH was first defined in 2011 International Classification of Disease-9th edition(ICD-9)as a separate diagnosis;the HH cohort is extracted from January 2011 to December 2019 using 275.01(ICD-9)and E83.110(ICD-10)diagnosis codes of HH.Patients were excluded from the HH cohort if they had a primary or secondary diagnostic code of cirrhosis(alcoholic,non-alcoholic,and biliary),viralhepatitis,alcoholic liver disease,non-alcoholic fatty liver disease(NAFLD),and non-alcoholic steatohepatitis(NASH).We removed these patients from the HH cohort to rule out bias or ICD-10 diagnostic errors.The HCC cohort is selected from January 2011 to December 2019 using the ICD-9 and ICD-10 codes of HCC.We selected a non-HCC cohort with the 1:1 fixed ratio nearest neighbor(greedy)propensity score method using the patients'age,gender,and race.We performed multivariate analysis for the risk factors of HCC in the HCC and non-HCC matched cohort.We further analyzed HH without cirrhosis(removing HH patients with a diagnosis of cirrhosis)as an independent risk factor of HCC after adjusting all known risk factors of HCC in the multivariate model.RESULTS During the 2011-2019 period,a total of 18031 hospitalizations with a primary or secon

关 键 词：Hereditary hemochromatosis Hepatocellular carcinoma cirrhosis Hepatitis Diabetes mellitus Nonalcoholic fatty liver disease Nonalcoholic steatohepatitis Wilson disease Alpha1-antitrypsin deficiency Blood transfusion Epidemiology Demographics Big data HOSPITALIZATION 

分 类 号：R735.7[医药卫生—肿瘤]