Increased risk of cirrhosis and its decompensation in chronic hepatitis B patients with newly diagnosed diabetes: A nationwide cohort study

Yi Wen Huang, Ting Chuan Wang, Shih Chang Lin, Han Yu Chang, Ding Shinn Chen, Jui Ting Hu, Sien Sing Yang, Jia Horng Kao

研究成果: 雜誌貢獻文章同行評審

70 引文 斯高帕斯(Scopus)

摘要

Background. The impact of diabetes on cirrhosis, its decompensation, and their time relationship in patients with chronic hepatitis B (CHB) remain unclear.Methods. We conducted a nationwide cohort study by using the Taiwanese National Health Insurance Research Database, which was comprised of data from >99% of the entire population. Among 1 million randomly sampled enrollees, 14 523 adult CHB patients were identified from 1997 to 2009. Diabetes was defined as newly diagnosed in CHB patients who were given the diagnosis in the years 1998-2001 but not in 1996-1997 and with physician visits of at least twice per year. The cohorts of CHB with newly diagnosed diabetes (n = 351) and without diabetes (n = 7886) were followed up from the diagnosis of diabetes and from 2000 in the patients without diabetes until development of cirrhosis or its decompensation, withdrawal from insurance, or December 2009.Results. Kaplan-Meier survival analysis showed a significantly higher cumulative incidence of cirrhosis (relative risk [RR] = 3.43; 95% confidence interval [CI], 2.62-4.49; P <. 001, log-rank test) and decompensated cirrhosis (RR = 4.11; 95% CI, 2.95-5.70; P <. 001, log-rank test) among patients with newly developed diabetes compared with those without diabetes. After adjustment for age, sex, CHB treatment, hepatocellular carcinoma, and comorbidity index by Cox proportional hazards model, diabetes was still an independent predictor for cirrhosis (hazard ratio [HR] = 2.015; 95% CI, 1.393-2.915; P <. 001) and its decompensation (HR = 1.792; 95% CI, 1.192-2.695; P =. 005).Conclusions. Patients with CHB who develop diabetes are at an increased risk of liver cirrhosis and its decompensation over time.

原文英語
頁(從 - 到)1695-1702
頁數8
期刊Clinical Infectious Diseases
57
發行號12
DOIs
出版狀態已發佈 - 12月 2013

ASJC Scopus subject areas

  • 微生物學(醫學)
  • 傳染性疾病

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