caa a22 4500 445887834 CHVBK 20180317145605.0 cr unu---uuuuu 170323e20110601xx s 000 0 eng 10.1007/s00535-011-0381-2 doi (NATIONALLICENCE)springer-10.1007/s00535-011-0381-2 Post-challenge hyperglycemia is a significant risk factor for the development of hepatocellular carcinoma in patients with chronic hepatitis C [Elektronische Daten] [Hirokazu Takahashi, Toshihiko Mizuta, Yuichiro Eguchi, Yasunori Kawaguchi, Takuya Kuwashiro, Satoshi Oeda, Hiroshi Isoda, Noriko Oza, Shinji Iwane, Kenichi Izumi, Keizou Anzai, Iwata Ozaki, Kazuma Fujimoto] Background: Several epidemiological studies have reported that diabetes mellitus is a risk factor for hepatocellular carcinoma (HCC) in hepatitis C virus (HCV)-positive patients. However, it is unclear whether or not post-challenge hyperglycemia is a risk factor. The purpose of this study was to determine the association between post-challenge hyperglycemia and hepatocarcinogenesis in HCV-positive patients. Methods: A total of 203 HCV-RNA-positive subjects (108 males, mean age 54.3±10.8years; 95 females, mean age 56.6±10.3years; genotype 1b/2a/2b/3a: 152/38/12/1) who underwent liver biopsy and a 75-g oral glucose tolerance test, and who were treated with interferon (IFN) were enrolled in this study. None of the subjects had been treated with antidiabetic drugs. The subjects underwent ultrasonography and/or computed tomography every 6months after the end of the IFN therapy. Results: Thirteen patients, including one patient who achieved a sustained viral response (SVR) with IFN, developed HCC. On multivariate analysis, male sex, age >65years, excessive alcohol consumption, non-SVR, liver steatosis area >5% in liver specimens, and 120-min post-challenge hyperglycemia were risk factors for the development of HCC. After matching subjects for sex, age, alcohol intake, and response to the IFN therapy, advanced fibrosis stages [hazard ratio (HR) 2.8], liver steatosis (HR 5.4), and 120-min post-challenge hyperglycemia (HR 4.9) were significant risk factors for the development of HCC. Furthermore, after matching for the fibrosis stage, liver steatosis (HR 5.7) and 120-min post-challenge hyperglycemia (HR 6.9) remained as significant factors for HCC development. Conclusion: Post-challenge hyperglycemia is an independent risk factor for HCC in HCV-positive patients. Springer, 2011 Hyperglycemia nationallicence Oral glucose tolerance test nationallicence Hepatocellular carcinoma nationallicence Hepatitis C nationallicence HCV : Hepatitis C virus nationallicence HBV : Hepatitis B virus nationallicence HCC : Hepatocellular carcinoma nationallicence DM : Diabetes mellitus nationallicence HR : Hazard ratio nationallicence BMI : Body mass index nationallicence ALT : Alanine aminotransferase nationallicence HbA1c : Hemoglobin A1c nationallicence IFN : Interferon nationallicence OGTT : Oral glucose tolerance test nationallicence PCR : Polymerase chain reaction nationallicence HOMA-IR : Homeostasis model assessment for insulin resistance nationallicence SVR : Sustained viral response nationallicence Takahashi Hirokazu Department of Internal Medicine, Saga Medical School, Nabeshima, Saga, Japan aut Mizuta Toshihiko Department of Internal Medicine, Saga Medical School, Nabeshima, Saga, Japan aut Eguchi Yuichiro Department of Internal Medicine, Saga Medical School, Nabeshima, Saga, Japan aut Kawaguchi Yasunori Department of Internal Medicine, Saga Medical School, Nabeshima, Saga, Japan aut Kuwashiro Takuya Department of Internal Medicine, Saga Medical School, Nabeshima, Saga, Japan aut Oeda Satoshi Department of Internal Medicine, Saga Medical School, Nabeshima, Saga, Japan aut Isoda Hiroshi Department of Internal Medicine, Saga Medical School, Nabeshima, Saga, Japan aut Oza Noriko Department of Internal Medicine, Saga Medical School, Nabeshima, Saga, Japan aut Iwane Shinji Department of Internal Medicine, Saga Medical School, Nabeshima, Saga, Japan aut Izumi Kenichi Department of Internal Medicine, Saga Medical School, Nabeshima, Saga, Japan aut Anzai Keizou Department of Internal Medicine, Saga Medical School, Nabeshima, Saga, Japan aut Ozaki Iwata Department of Internal Medicine, Saga Medical School, Nabeshima, Saga, Japan aut Fujimoto Kazuma Department of Internal Medicine, Saga Medical School, Nabeshima, Saga, Japan aut Journal of Gastroenterology Springer Japan 46/6(2011-06-01), 790-798 0944-1174 46:6<790 2011 46 535 https://doi.org/10.1007/s00535-011-0381-2 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00535-011-0381-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Takahashi Hirokazu Department of Internal Medicine, Saga Medical School, Nabeshima, Saga, Japan aut NATIONALLICENCE 700 1- Mizuta Toshihiko Department of Internal Medicine, Saga Medical School, Nabeshima, Saga, Japan aut NATIONALLICENCE 700 1- Eguchi Yuichiro Department of Internal Medicine, Saga Medical School, Nabeshima, Saga, Japan aut NATIONALLICENCE 700 1- Kawaguchi Yasunori Department of Internal Medicine, Saga Medical School, Nabeshima, Saga, Japan aut NATIONALLICENCE 700 1- Kuwashiro Takuya Department of Internal Medicine, Saga Medical School, Nabeshima, Saga, Japan aut NATIONALLICENCE 700 1- Oeda Satoshi Department of Internal Medicine, Saga Medical School, Nabeshima, Saga, Japan aut NATIONALLICENCE 700 1- Isoda Hiroshi Department of Internal Medicine, Saga Medical School, Nabeshima, Saga, Japan aut NATIONALLICENCE 700 1- Oza Noriko Department of Internal Medicine, Saga Medical School, Nabeshima, Saga, Japan aut NATIONALLICENCE 700 1- Iwane Shinji Department of Internal Medicine, Saga Medical School, Nabeshima, Saga, Japan aut NATIONALLICENCE 700 1- Izumi Kenichi Department of Internal Medicine, Saga Medical School, Nabeshima, Saga, Japan aut NATIONALLICENCE 700 1- Anzai Keizou Department of Internal Medicine, Saga Medical School, Nabeshima, Saga, Japan aut NATIONALLICENCE 700 1- Ozaki Iwata Department of Internal Medicine, Saga Medical School, Nabeshima, Saga, Japan aut NATIONALLICENCE 700 1- Fujimoto Kazuma Department of Internal Medicine, Saga Medical School, Nabeshima, Saga, Japan aut NATIONALLICENCE 773 0- Journal of Gastroenterology Springer Japan 46/6(2011-06-01), 790-798 0944-1174 46:6<790 2011 46 535 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer