Diabetes Mellitus and Prediabetes in Patients with Hepatocellular Carcinoma in a Tertiary Philippine Hospital

Katherine Anne Banal; Elizabeth Paz-Pacheco; Vanessa de Villa

doi:10.15605/jafes.032.01.06

Diabetes Mellitus and Prediabetes in Patients with Hepatocellular Carcinoma in a Tertiary Philippine Hospital

J ASEAN Fed Endocr Soc. 2017;32(1):32-37. doi: 10.15605/jafes.032.01.06. Epub 2017 May 4.

Authors

Katherine Anne Banal¹, Elizabeth Paz-Pacheco¹, Vanessa de Villa²

Affiliations

¹ Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, The Medical City, Pasig City, Philippines.
² Center for Liver Disease Management and Transplantation, The Medical City, Pasig City, Philippines.

Abstract

Background: Diabetes mellitus (DM) has been shown to be associated with an increased risk for hepatocellular carcinoma (HCC). DM and obesity are coexisting conditions that can increase the risk and severity of nonalcoholic fatty liver disease (NAFLD), leading to HCC even in the absence of cirrhosis. With the rising incidence of HCC and DM worldwide, it is important to identify the clinical characteristics of individuals with DM among those with HCC in our local setting.

Objectives: To determine the prevalence of DM among Filipino patients with HCC at our institution, determine their demographic and clinical profile, and compare the characteristics of HCC patients with and without DM.

Methodology: This is a retrospective, analytical, cross-sectional study involving patients with HCC seen at The Medical City's Center for Liver Disease Management and Transplantation from January 2010 to December 2014. A chart review was conducted and patients were grouped according to the presence or absence of DM. Data on demographics, body mass index (BMI), comorbidities, social and family history, risk factors for liver disease, and laboratory test results were gathered. STATA 12.0 was used for data analysis.

Results: We included 180 patients with HCC in the analysis. The prevalence of type 2 DM and prediabetes was 52.78%. The median age of patients with DM and prediabetes was 65 years, and 58 years for patients without DM (p=0.002). The average BMI was 27.35 + 4.68 for patients with DM, and 25.04 + 5.11 for those without DM (p=0.002). Among the patients without DM, 50.59% had hepatitis B virus (HBV) infection compared to 24.21% of patients with DM (p=0.000). Twenty one percent of patients with DM had cryptogenic cirrhosis compared to 8.24% of patients without DM (p=0.016). Patients with DM had a higher proportion of hypertension (66.32% vs. 42.35%, p=0.001) and dyslipidemia (48.42% vs. 10.59%, p=0.000).

Conclusion: The prevalence of DM and prediabetes among HCC patients is higher in our institution compared to findings from previous studies. HCC patients with DM were older, and had increased BMI, higher proportion of hypertension and dyslipidemia, lower incidence of HBV infection, and higher incidence of cryptogenic cirrhosis.

Keywords: diabetes mellitus; hepatocellular carcinoma.