SGLT2i reduces risk of developing HCC in patients with co-existing type 2 diabetes and hepatitis B infection: A territory-wide cohort study in Hong Kong

被引:18
作者
Lee, Chi-Ho [1 ,2 ]
Mak, Lung-Yi [1 ,3 ]
Tang, Eric Ho-Man [4 ]
Lui, David Tak-Wai [1 ]
Mak, Jimmy Ho-Cheung [1 ]
Li, Lanlan [4 ]
Wu, Tingting [4 ]
Chan, Wing Lok [5 ]
Yuen, Man-Fung [1 ,3 ]
Lam, Karen Siu-Ling [1 ,2 ]
Wong, Carlos King Ho [4 ,6 ,7 ,8 ]
机构
[1] Univ Hong Kong, Li Ka Shing Fac Med, Sch Clin Med, Dept Med, Hong Kong, Peoples R China
[2] Univ Hong Kong, State Key Lab Pharmaceut Biotechnol, Hong Kong, Peoples R China
[3] Univ Hong Kong, State Key Lab Liver Res, Hong Kong, Peoples R China
[4] Univ Hong Kong, Li Ka Shing Fac Med, Sch Clin Med, Dept Family Med & Primary Care, Hong Kong, Peoples R China
[5] Univ Hong Kong, Li Ka Shing Fac Med, Sch Clin Med, Dept Clin Oncol, Hong Kong, Peoples R China
[6] Univ Hong Kong, Li Ka Shing Fac Med, Dept Pharmacol & Pharm, Hong Kong, Peoples R China
[7] Lab Data Discovery Hlth D24H, Hong Kong Sci & Technol Pk, Hong Kong, Peoples R China
[8] Univ Hong Kong, Li Ka Shing Fac Med, Dept Pharmacol & Pharm, Pokfulam, Rm 1-01,1-F,Jockey Club AQ5 Bldg Interdisciplinary, Hong Kong, Peoples R China
关键词
FATTY LIVER-DISEASE; HEPATOCELLULAR-CARCINOMA; MELLITUS; POPULATION; INHIBITORS; FIBROSIS; SYSTEM; VIRUS;
D O I
10.1097/HEP.0000000000000404
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background and Aims: Type 2 diabetes (T2D) and chronic hepatitis B infection (CHB) are risk factors of HCC. Sodium glucose co-transporter 2 inhibitors (SGLT2i) inhibit HCC oncogenesis in preclinical studies. However, clinical studies are lacking. This study aimed to evaluate the impact of SGLT2i use on incident HCC using a territory-wide cohort of exclusively patients with co-existing T2D and CHB. Approach and Results: Patients with co-existing T2D and CHB between 2015 and 2020 were identified from the representative electronic database of the Hong Kong Hospital Authority. Patients with and without SGLT2i use were 1:1 matched by propensity score for their demographics, biochemistry results, liver-related characteristics, and background medications. Cox proportional hazards regression model was used to assess the association between SGLT2i use and incident HCC. A total of 2,000 patients with co-existing T2D and CHB (1,000 in each SGLT2i and non-SGLT2i group; 79.7% on anti-HBV therapy at baseline) were included after propensity-score matching. Over a follow-up of 3,704 person-years, the incidence rates of HCC were 1.39 and 2.52 cases per 100 person-year in SGLT2i and non-SGLT2i groups, respectively. SGLT2i use was associated with a significantly lower risk of incident HCC (HR 0.54, 95%CI: 0.33-0.88, p=0.013). The association remained similar regardless of sex, age, glycemic control, diabetes duration, presence of cirrhosis and hepatic steatosis, timing of anti-HBV therapy, and background antidiabetic agents including dipeptidyl peptidase-4 inhibitors, insulin, or glitazones (all p interaction>0.05). Conclusions: Among patients with co-existing T2D and CHB, SGLT2i use was associated with a lower risk of incident HCC.
引用
收藏
页码:1569 / 1580
页数:12
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