ArticleJournal of gastroenterology2021
Hepatocellular carcinoma development in diabetic patients: a nationwide survey in Japan.
Article in Journal of gastroenterology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed, 48 citations in OpenAlex.
- The Impact of Rifaximin on Hepatic Encephalopathy during Lenvatinib Therapy in Patients with Hepatocellular Carcinoma and Splenorenal Shunt.Internal medicine (Tokyo, Japan) · 2026Article
- Diabetes as a Risk Factor for Sarcopenia in Patients with MASH-Related Cirrhosis.Journal of clinical medicine · 2025Article
- Usefulness of the Fibrosis-3 index in patients with hepatitis C.Annals of medicine and surgery (2012) · 2025Article
- Review
- Assessment of Macrovascular Invasion in Advanced Hepatocellular Carcinoma: Clinical Implications and Treatment Outcomes with Systemic Therapy.Liver cancer · 2025Article
- Article
- Rethinking Diabetes from the Perspective of Diverse Insulin Actions in Various Organs.JMA journal · 2024Review
- The Role of Type 2 Diabetes Mellitus-Related Risk Factors and Drugs in Hepatocellular Carcinoma.Journal of hepatocellular carcinoma · 2024Review
- Clinical Characteristics of Non-B and Non-C Biopsy-Proven Primary Liver Cancers in an HBV- Endemic Area: A Retrospective Study.Journal of hepatocellular carcinoma · 2024Article
- Exploring mechanisms underlying diabetes comorbidities and strategies to prevent vascular complications.Diabetology international · 2024Review
- Efficacy and safety of atezolizumab plus bevacizumab treatment for unresectable hepatocellular carcinoma patients with esophageal-gastric varices.Journal of gastroenterology · 2023Article
- Frontiers of Collaboration between Primary Care and Specialists in the Management of Metabolic Dysfunction-Associated Steatotic Liver Disease: A Review.Life (Basel, Switzerland) · 2023Review
- Immunohistochemical expression of NRF2 is correlated with the magnitude of inflammation and fibrosis in chronic liver disease.Cancer medicine · 2023Article
- Pathogenesis of Hepatocellular Carcinoma: The Interplay of Apoptosis and Autophagy.Biomedicines · 2023Review
- Development and prognosis of hepatocellular carcinoma in patients with diabetes.Clinical and molecular hepatology · 2023Review
- Current status of liver transplantation for non-B non-C liver cirrhosis and hepatocellular carcinoma.Annals of gastroenterological surgery · 2023Review
- Article
- Risk factors and diagnostic biomarkers for nonalcoholic fatty liver disease-associated hepatocellular carcinoma: Current evidence and future perspectives.World journal of gastroenterology · 2022Review
- MAFLD enhances clinical practice for liver disease in the Asia-Pacific region.Clinical and molecular hepatology · 2022Review
- Article
Corrections and comments
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Authors and funding
27 authors at 10 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough type 2 diabetes mellitus (T2DM) is a known risk factor for hepatocellular carcinoma (HCC) development, the annual incidence in diabetes patients is far below the threshold of efficient surveillance. This study aimed to elucidate the risk factors for HCC in diabetic patients and to determine the best criteria to identify surveillance candidates.
methodsThe study included 239 patients with T2DM who were diagnosed with non-viral HCC between 2010 and 2015, with ≥ 5 years of follow-up at diabetes clinics of 81 teaching hospitals in Japan before HCC diagnosis, and 3277 non-HCC T2DM patients from a prospective cohort study, as controls. Clinical data at the time of and 5 years before HCC diagnosis were collected.
resultsThe mean patient age at HCC diagnosis was approximately 73 years, and 80% of the patients were male. The proportion of patients with insulin use increased, whereas the body mass index (BMI), proportion of patients with fatty liver, fasting glucose levels, and hemoglobin A1c (HbA1c) levels decreased significantly in 5 years. In the cohort study, 18 patients developed HCC during the mean follow-up period of 4.7 years with an annual incidence of 0.11%. Multivariate logistic regression analyses showed that the FIB-4 index was an outstanding predictor of HCC development along with male sex, presence of hypertension, lower HbA1c and albumin levels, and higher BMI and gamma-glutamyl transpeptidase levels. Receiver-operating characteristic analyses showed that a FIB-4 cut-off value of 3.61 could help identify high-risk patients, with a corresponding annual HCC incidence rate of 1.1%.
conclusionA simple calculation of the FIB-4 index in diabetes clinics can be the first step toward surveillance of HCC with a non-viral etiology.
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