hepatitis B

Could Insulin Resistance Raise HCC Risk in Patients with Hep B?

Insulin resistance is associated with the risk of developing hepatocellular carcinoma (HCC) in patients with chronic hepatitis B virus (HBV), especially in without overt metabolic abnormalities, according to the results of a recent study.

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The researchers conducted a retrospective cohort study of 1696 chronic HBV-infected patients who underwent C-peptide and fasting blood glucose measurements. Participants were followed up for more than 1 year.

Over a median follow-up of 5 years, 24 patients developed HCC. Incidence rate for HCC was higher in patients with higher homeostasis model assessment (HOMA2-IR) value than those with lower value, and HOMA2-IR value was a significant factor associated with HCC development in multivariable-adjusted models. The association ceased being significant, however, after adjusting for obesity, hypertension, and diabetes.

In subgroup analyses, HOMA2-IR was an independent factor associated with HCC in patients without hypertension, diabetes, and metabolic syndrome, but not in patients with overt metabolic abnormalities.

“Insulin resistance assessed by HOMA2 was associated with the risk of HCC, indicating that HOMA2-IR can be a useful tool for stratifying the risk of HCC in chronic HBV-infected patients, particularly in patients without overt metabolic abnormalities.”

—Michael Potts

Reference:

Kim JH, Sinn DH, Gwak G, et al. Insulin resistance and the risk of hepatocellular carcinoma in chronic hepatitis B patients [published online April 27, 2017]. JGH. http://onlinelibrary.wiley.com/doi/10.1111/jgh.13647/full.