【medical-news】CID：糖尿病增加CHB患者肝硬化及失代偿的风险
xxll2006 +2 丁当这个帖子发布于 11 年零 269 天前，其中的信息可能已发生改变或有所发展。
Increased risk of cirrhosis and its decompensation in chronic hepatitis B patients with new onset diabetes: A nationwide cohort study
Abstract
Background.
Impact of diabetes on cirrhosis, its decompensation and their time-relationship in chronic hepatitis B (CHB) patients remains unclear.?
Methods.We conducted a nationwide cohort study by using Taiwanese National Health Insurance Research Database, which comprised of data from? >99% of entire population. Among randomly sampled one million enrollees, 14,523 adult CHB patients were identified from 1997-2009. Diabetes was defined as newly diagnosed in CHB patients who were given the diagnosis in the years 1999-2000 but not in 1996-1998 and with physician visits of at least 2 times per year. The cohorts of CHB with newly diagnosed diabetes (n=351) and non-diabetes (n=7,886) were followed-up from inception point in diabetes and from year 2000 in the non-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=3.43, 95%CI=2.62-4.49, log-rank test, p?<0.001) and decompensated cirrhosis (Relative Risk=4.11, 95%CI=2.95-5.70, log-rank test, p<0.001) among patients with newly developed diabetes as compared with those without. After adjustment for age, gender, CHB treatment, hepatocellular carcinoma, and comorbidity index by Cox proportional hazard model, diabetes was still an independent predictor for cirrhosis (hazard ratio=2.015, 95%CI=1.393-2.915, p<0.001) and its decompensation (hazard ratio=1.792, 95%CI=1.192-2.695, p=0.005).
Conclusion.CHB patients who develop diabetes are at an increased risk of liver cirrhosis and its decompensation over time.?
Abstract
Background.
Impact of diabetes on cirrhosis, its decompensation and their time-relationship in chronic hepatitis B (CHB) patients remains unclear.?
Methods.We conducted a nationwide cohort study by using Taiwanese National Health Insurance Research Database, which comprised of data from? >99% of entire population. Among randomly sampled one million enrollees, 14,523 adult CHB patients were identified from 1997-2009. Diabetes was defined as newly diagnosed in CHB patients who were given the diagnosis in the years 1999-2000 but not in 1996-1998 and with physician visits of at least 2 times per year. The cohorts of CHB with newly diagnosed diabetes (n=351) and non-diabetes (n=7,886) were followed-up from inception point in diabetes and from year 2000 in the non-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=3.43, 95%CI=2.62-4.49, log-rank test, p?<0.001) and decompensated cirrhosis (Relative Risk=4.11, 95%CI=2.95-5.70, log-rank test, p<0.001) among patients with newly developed diabetes as compared with those without. After adjustment for age, gender, CHB treatment, hepatocellular carcinoma, and comorbidity index by Cox proportional hazard model, diabetes was still an independent predictor for cirrhosis (hazard ratio=2.015, 95%CI=1.393-2.915, p<0.001) and its decompensation (hazard ratio=1.792, 95%CI=1.192-2.695, p=0.005).
Conclusion.CHB patients who develop diabetes are at an increased risk of liver cirrhosis and its decompensation over time.?
