Toshihide Shima
Kyoto Prefectural University, Japan
Title: Hepatocellular carcinoma as a leading cause of cancer-related deaths in Japanese type 2 diabetes mellitus patients
Biography
Biography: Toshihide Shima
Abstract
We reported a cross-sectional study on causes of liver injury in Japanese type 2 diabetes mellitus (T2D) patients (J of Gastroenterology 48, 2013). We assessed overall and cause-specific mortality risk during follow-up of patients enrolled in JG 2013.
Methods: Of the 5,642 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-speciï¬c mortality rates in the general population (GP) of Japan. Standardized mortality ratios (SMRs) were calculated to compare mortality between T2D patients and GP.
Results: All-cancer mortality was signiï¬cantly higher in T2D patients than in GP [SMR 1.58, 95% confidence interval (CI) 1.21–2.06], whereas all-cause mortality was comparable between the groups (SMR 1.10, 95% CI 0.93–1.32). Among malignancies, hepatocellular carcinoma (HCC) conferred the highest mortality risk in T2D patients (SMR 3.57, 95% CI 1.66–7.67). HCC-associated mortality risk in T2D patients remained significantly high (SMR 2.56, 95% CI 1.15–5.68) 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 × 103/μl, SMR of HCC increased from 3.57 to 6.58 (95% CI 2.33–18.60).
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 × 103/μl for early detection of HCC.