Hepatocellular carcinoma as a leading cause of cancer-related deaths in Japanese type 2 diabetes mellitus patients.


Journal

Journal of gastroenterology
ISSN: 1435-5922
Titre abrégé: J Gastroenterol
Pays: Japan
ID NLM: 9430794

Informations de publication

Date de publication:
Jan 2019
Historique:
received: 16 12 2017
accepted: 30 06 2018
pubmed: 15 7 2018
medline: 18 12 2019
entrez: 15 7 2018
Statut: ppublish

Résumé

We reported a cross-sectional study on causes of liver injury in Japanese type 2 diabetes mellitus (T2D) patients (JG 2013). We assessed overall and cause-specific mortality risk during follow-up of patients enrolled in JG 2013. This was a longitudinal, multicenter cohort study. Of the 5642 Japanese T2D patients who visited T2D clinics of nine hospitals in the original study, 3,999 patients were followed up for an average of 4.5 years. Expected deaths in T2D patients were estimated using age-specific mortality rates in the general population (GP) of Japan. Standardized mortality ratios (SMRs) were calculated to compare mortality between T2D patients and GP. All-cancer mortality was significantly higher in T2D patients than in the GP [SMR 1.58, 95% confidence interval (CI) 1.33-1.87]. Among malignancies, hepatocellular carcinoma (HCC) conferred the highest mortality risk in T2D patients (SMR 3.57, 95% CI 2.41-5.10). HCC-associated mortality risk in T2D patients remained significantly high (SMR 2.56, 95% CI 1.64-3.97) after adjusting for high positivity rates of hepatitis B surface antigen (1.7%) and anti-hepatitis C virus (5.3%). In T2D patients with platelet counts < 200 × 10 HCC-associated mortality risk was the highest among all cancers in Japanese T2D patients. Regular follow-up may be important for T2D patients with platelet counts < 200 × 10

Sections du résumé

BACKGROUND BACKGROUND
We reported a cross-sectional study on causes of liver injury in Japanese type 2 diabetes mellitus (T2D) patients (JG 2013). We assessed overall and cause-specific mortality risk during follow-up of patients enrolled in JG 2013.
METHODS METHODS
This was a longitudinal, multicenter cohort study. Of the 5642 Japanese T2D patients who visited T2D clinics of nine hospitals in the original study, 3,999 patients were followed up for an average of 4.5 years. Expected deaths in T2D patients were estimated using age-specific mortality rates in the general population (GP) of Japan. Standardized mortality ratios (SMRs) were calculated to compare mortality between T2D patients and GP.
RESULTS RESULTS
All-cancer mortality was significantly higher in T2D patients than in the GP [SMR 1.58, 95% confidence interval (CI) 1.33-1.87]. Among malignancies, hepatocellular carcinoma (HCC) conferred the highest mortality risk in T2D patients (SMR 3.57, 95% CI 2.41-5.10). HCC-associated mortality risk in T2D patients remained significantly high (SMR 2.56, 95% CI 1.64-3.97) after adjusting for high positivity rates of hepatitis B surface antigen (1.7%) and anti-hepatitis C virus (5.3%). In T2D patients with platelet counts < 200 × 10
CONCLUSIONS CONCLUSIONS
HCC-associated mortality risk was the highest among all cancers in Japanese T2D patients. Regular follow-up may be important for T2D patients with platelet counts < 200 × 10

Identifiants

pubmed: 30006904
doi: 10.1007/s00535-018-1494-7
pii: 10.1007/s00535-018-1494-7
doi:

Substances chimiques

Hepatitis B Surface Antigens 0

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

64-77

Subventions

Organisme : Grant-in-Aid from the Ministry of Health, Labour and Welfare, Japan
ID : H20-Hepatitis-general-008
Organisme : Japan Agency for Medical Research and Development
ID : the Research Program on Hepatitis

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Auteurs

Toshihide Shima (T)

Department of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Suita, Japan.

Hirofumi Uto (H)

Department of Digestive and Lifestyle Diseases, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.

Kohjiro Ueki (K)

Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

Yutaka Kohgo (Y)

Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical College, Asahikawa, Japan.

Kohichiroh Yasui (K)

Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Naoto Nakamura (N)

Department of Endocrinology Diabetes and Metabolism, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Tatsuaki Nakatou (T)

Diabetes Center, Okayama Saiseikai General Hospital, Okayama, Japan.

Toshinari Takamura (T)

Department of Endocrinology and Metabolism, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.

Sumio Kawata (S)

Department of Gastroenterology, Yamagata University Faculty of Medicine, Yamagata, Japan.

Kazuo Notsumata (K)

Department of Gastroenterology, Fukui-ken Saiseikai Hospital, Fukui, Japan.

Kyoko Sakai (K)

Department of Clinical Laboratory, Saiseikai Suita Hospital, Suita, Japan.
Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan.

Ryosuke Tateishi (R)

Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

Takeshi Okanoue (T)

Department of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Suita, Japan. okanoue@suita.saiseikai.or.jp.

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