Investigating the impact of concurrent type 2 diabetes on the occurrence of liver cancer in 2501 patients with chronic hepatitis B

Abstract Purpose Exploring the occurrence of adverse outcomes time in patients with chronic Hepatitis B virus infection and type 2 diabetes mellitus who develop liver cancer.Methods A total of 2501 patients who were hospitalized at Shenzhen Third People’s Hospital from January 2017 to January 2023 and met the inclusion criteria were collected. The patients were divided into diabetes group and non-diabetes group based on whether they had type 2 diabetes at admission. Through subsequent follow-ups, the occurrence of liver cancer in the two groups of patients during the follow-up period was observed, with follow-up time ending in January 2014. At the same time, the Cox proportional hazard regression model was used to analyze the impact of coexisting type 2 diabetes on the risk of developing hepatitis B virus-related liver cancer.Results 2,501 patients were followed up on average for 43.8 ± 5.2 months, with a total of 23 cases of liver cancer occurring during the follow-up period. Among them, 61 patients were diagnosed with type 2 diabetes (diabetes group), with an average follow-up duration of 44.7 ± 9.6 months and 7 cases of liver cancer occurring during the follow-up period, with a 5-year cumulative incidence of liver cancer of 15%. In the non-diabetes group of 2,440 patients, the average follow-up duration was 43.8 ± 5.0 months, with 16 cases of liver cancer occurring during the follow-up period and a 5-year cumulative incidence of liver cancer of 2.3%. The difference in cumulative incidence of liver cancer between the two groups was statistically significant (P < 0.05). Results of Cox univariate regression analysis showed that the risk of liver cancer in the diabetes group was 6.968 times higher than that in the non-diabetes group (95% confidence interval, CI: 2.240–21.671, P = 0.02); after adjusting for factors such as age, gender, history of hepatitis B, family history of liver cancer, antiviral treatment, different liver inflammation and fibrosis, and alcohol consumption in the Cox regression multivariate analysis, the risk of liver cancer in diabetic patients with hepatitis B virus infection was 3.833 times higher than that in the non-diabetes group (95% CI: 1.134–12.952, P = 0.031).Conclusion Type 2 diabetes and hepatitis B virus are related to the incidence of liver cancer, and the presence of type 2 diabetes increases the risk of liver cancer occurrence within 5 years in patients infected with hepatitis B virus.