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Chronic hepatitis B infection and diabetes mellitus: a double liver trouble?

Fadi Abu Baker1, Yana Davidov2, Areil Israel3

  • 1Department of Gastroenterology and Hepatology, Hillel Yaffe Medical Center, Faculty of Medicine, Technion University, Hadera, Israel.

Minerva Medica
|March 13, 2023
PubMed

Insights

Diabetes mellitus (DM) significantly increases cirrhosis risk in chronic hepatitis B (CHB) patients. This study found DM is independently associated with higher rates of cirrhosis and potentially hepatocellular carcinoma (HCC) in CHB individuals.

Area of Science:

  • Hepatology
  • Endocrinology
  • Epidemiology

Background:

  • Concomitant Diabetes mellitus (DM) is prevalent in chronic hepatitis B (CHB) patients.
  • The impact of DM on liver-related outcomes in CHB remains debated.

Purpose of the Study:

  • To evaluate the effect of DM on the clinical course, management, and outcomes of CHB patients.
  • To investigate the association between DM and the risk of cirrhosis and hepatocellular carcinoma (HCC) in CHB.

Main Methods:

  • A large retrospective cohort study using the Leumit Health Service (LHS) database (2000-2019).
  • Comparison of two cohorts: CHB with DM (CHD-DM, N.=252) and CHB without DM (N.=964).
  • Analysis included clinical parameters, treatment, outcomes, multivariable regression, and Cox regression.

Main Results:

  • CHD-DM patients were older, with higher rates of obesity and non-alcoholic fatty liver disease (NAFLD).
  • HBeAg seroconversion rates were lower in the CHB-DM group (25% vs. 45.7%).
  • DM was independently associated with increased cirrhosis risk (HR 2.63; P=0.002).

Conclusions:

  • Concomitant DM is significantly and independently associated with cirrhosis in CHB patients.
  • DM may also be associated with an increased risk of HCC in CHB patients, though further research is needed due to limited HCC cases.
Abstract

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