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|Title: ||Interaction and joint effect of ALT and chronic liver disease on liver cancer in type 2 diabetes patients|
|Authors: ||李采娟;Li, Chia-Ing;Li, Chia-Ing;Chiu-Shong, L;Liu, Chiu-Shong;Li, Pao-Hsuan;Lin, Pao-Hsuan;Lin, Wen-Yuan;Lin, Wen-Yuan;Chih-Hsueh, L;Lin, Chih-Hsueh;Yang, Sing-Yu;Yang, Sing-Yu;Chi, Jen-Huai;Chiang, Jen-Huai;林正介|
|Issue Date: ||2017-12-22 15:12:20 (UTC+8)|
|Abstract: ||Background: This study examined whether serum alanine transaminase (ALT) and chronic liver diseases were interactively, jointly, or independently associated with hepatocellular carcinoma (HCC) risk in type 2 diabetic patients.
Materials and Methods: A retrospective cohort study was conducted in 46,369 Chinese type 2 diabetic patients, aged 30 and older, in National Diabetes Care Management Program in 2002-2004. These data were analyzed by multivariate Cox proportional hazards models.
Results: Mean follow-up period was 8.20 years. Multivariate-adjusted hazard ratios of HCC were 2.85 (95% confidence interval, CI: 2.45–3.31), 3.80 (3.04–4.76), and 3.89 (3.08–4.91) for patients with a level of ALT 40–80, 80–120, and >120 U/L, respectively, compared with patients with a level of ALT < 40 U/L after multivariable adjustment. Significant hazard ratios of HCC for patients with a level of ALT ≥ 40 U/L and alcoholic liver damage, nonalcoholic fatty liver disease, liver cirrhosis, hepatitis B virus and hepatitis C virus infection, or any one of these chronic liver diseases compared with patients with ALT level < 40 U/L and no counterpart comorbidity were observed. Significant effect modifications were observed between ALT level with liver cirrhosis and HBV.
Conclusions: Results suggest significant effect modification and joint associations of ALT ≥ 40 U/L and chronic liver diseases. Diabetes care should provide lifestyle or treatment interventions to manage ALT level, liver cirrhosis and hepatitis B virus infection for reducing burden of HCC.
|Appears in Collections:||[健康產業管理學系] 期刊論文|
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