血糖控制是肝细胞癌和糖尿病患者肝脏相关死亡的可修改风险因素
Xianhua Mao1,2, Ka-Shing Cheung1,2, Jing-Tong Tan1
1Department of Medicine, School of Clinical Medicine, the University of Hong Kong, Hong Kong.
Alimentary pharmacology & therapeutics
|September 10, 2024
概括
在糖尿病患者 (DM) 中保持最佳的血糖控制显著降低了患肝细胞癌 (HCC) 和肝脏相关死亡的风险. 这凸显了血糖管理对肝脏健康的重要性.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
背景情况:
- 优化血糖控制对于管理糖尿病并发症至关重要.
- 血糖控制对肝脏特异性结果,如肝细胞癌 (HCC) 和肝脏死亡率的影响仍然不清楚.
研究的目的:
- 调查最佳血糖控制与发展HCC的风险之间的关联.
- 检查DM患者的最佳血糖控制和肝脏相关死亡率之间的关系.
主要方法:
- 香港的一项基于人口的队列研究确定了新诊断的DM患者 (2001-2016).
- 最佳血糖控制被定义为在诊断后的最初3年内平均血红蛋白A1c (HbA1c) <7%的平均水平.
- 倾向性得分匹配和竞争性风险模型被用于分析血糖控制和HCC/肝脏死亡率之间的关联.
主要成果:
- 该研究包括146430名患者,随访时间中位数为7.0年.
- 最佳的血糖控制与降低HCC风险 (SHR 0.70) 和与肝脏相关的死亡率 (SHR 0.70) 相关.
- 增加HbA1c水平超过7%与更高的HCC风险相关,独立于年龄,性别,BMI,吸烟和药物使用等因素.
结论:
- 血糖控制是DM患者中HCC和肝脏相关死亡率的独立风险因素.
- 建议将血糖控制纳入瘤保护策略,适用于一般的DM患者.
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