Diabetes and the risk of cirrhosis and HCC : An analysis of the UK Biobank
Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Association for the Study of Liver Diseases..
BACKGROUND: Diabetes increases the risk of cirrhosis and HCC. We aimed to assess such associations given different diabetes statuses.
METHODS: We included 449,497 participants in the UK Biobank cohort (mean age 56.7±8.0 y; 45.5% male) and assessed the association between preclinical diabetes (prediabetes, having a high risk of diabetes), clinical diabetes (presence, duration, or glycemic control of type 2 diabetes), and incident liver cirrhosis and HCC by the Cox regression. Liver diseases were ascertained through inpatient records and national death registration. Gene-environment interaction was examined using the polygenic risk scores of cirrhosis and HCC.
RESULTS: Compared with normoglycemia, having <5 years,≥5 years of diabetes showed adjusted HRs (aHRs) of cirrhosis as 2.85 (2.45-3.32) and 3.43 (2.92-4.02), respectively, which was similarly observed in HCC. In diabetes, a level of hemoglobin A1c ≥ 7.5% showed aHRs of 1.37 (1.07-1.76) and 1.89 (1.10-3.25) for cirrhosis and HCC, respectively, compared with hemoglobin A1c < 6.5%. In non-diabetes, prediabetes presented aHRs of 1.41 (1.14-1.73) and 1.80 (1.06-3.04) of cirrhosis and HCC, respectively. Participants with a high risk of diabetes at baseline showed an aHR of 3.31 (2.65-4.13) for cirrhosis and 2.09 (1.15-3.80) for HCC. In those with a high genetic risk of HCC, having an increased risk of diabetes posed a significantly higher risk of HCC (aHR: 1.93, 1.45-2.58, Pinteraction=0.005), compared with those without a high genetic risk of HCC.
CONCLUSIONS: Not only diabetes but preclinical diabetes, longer diabetes duration, and higher baseline hemoglobin A1c were associated with an increased risk of incident cirrhosis and HCC in the general population.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:7 |
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| Enthalten in: |
Hepatology communications - 7(2023), 11 vom: 01. Nov. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ye, Fangzhou [VerfasserIn] |
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| Anmerkungen: |
Date Completed 23.10.2023 Date Revised 12.02.2024 published: Electronic-eCollection Citation Status MEDLINE |
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| doi: |
10.1097/HC9.0000000000000280 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Association for the Study of Liver Diseases. | ||
| 520 | |a BACKGROUND: Diabetes increases the risk of cirrhosis and HCC. We aimed to assess such associations given different diabetes statuses | ||
| 520 | |a METHODS: We included 449,497 participants in the UK Biobank cohort (mean age 56.7±8.0 y; 45.5% male) and assessed the association between preclinical diabetes (prediabetes, having a high risk of diabetes), clinical diabetes (presence, duration, or glycemic control of type 2 diabetes), and incident liver cirrhosis and HCC by the Cox regression. Liver diseases were ascertained through inpatient records and national death registration. Gene-environment interaction was examined using the polygenic risk scores of cirrhosis and HCC | ||
| 520 | |a RESULTS: Compared with normoglycemia, having <5 years,≥5 years of diabetes showed adjusted HRs (aHRs) of cirrhosis as 2.85 (2.45-3.32) and 3.43 (2.92-4.02), respectively, which was similarly observed in HCC. In diabetes, a level of hemoglobin A1c ≥ 7.5% showed aHRs of 1.37 (1.07-1.76) and 1.89 (1.10-3.25) for cirrhosis and HCC, respectively, compared with hemoglobin A1c < 6.5%. In non-diabetes, prediabetes presented aHRs of 1.41 (1.14-1.73) and 1.80 (1.06-3.04) of cirrhosis and HCC, respectively. Participants with a high risk of diabetes at baseline showed an aHR of 3.31 (2.65-4.13) for cirrhosis and 2.09 (1.15-3.80) for HCC. In those with a high genetic risk of HCC, having an increased risk of diabetes posed a significantly higher risk of HCC (aHR: 1.93, 1.45-2.58, Pinteraction=0.005), compared with those without a high genetic risk of HCC | ||
| 520 | |a CONCLUSIONS: Not only diabetes but preclinical diabetes, longer diabetes duration, and higher baseline hemoglobin A1c were associated with an increased risk of incident cirrhosis and HCC in the general population | ||
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