Diabetes mellitus, insulin resistance and hepatitis C virus infection: A contemporary review

Table 5 Glucose abnormalities and hepatocellular carcinoma in hepatitis C virus-infected patients

Ref.	Year	Country	Patient number	Patient profile	Association	Statistical method	Association DM and HCC	Statistics
Diabetes mellitus/insulin resistance in HCV-related HCC
K-Kutala et al[15]	2014	France	162	HCC, not treated for HCV	DM and HCC	Multivariate	Yes3	HR = 3.13 [1.17, 8.38]; P = 0.0223
Hung et al[115]	2010	Taiwan	188	59 HCC; 129 non-HCC	DM and HCC	Multivariate	Yes	OR = 11.6 [2.500, 53.800]; P = 0.002
Hung et al[115]	2010	Taiwan	188	59 HCC; 129 non-HCC	HOMA-IR and HCC	Multivariate	Yes	OR = 2.0 [1.35, 3]; P = 0.001
Khattab et al[116]	2012	Egypt	294	147 HCC; 147 non-HCC	HOMA-IR and HCC	Multivariate	Yes	OR = 2.5 [1.7, 3.69]; P = 0.001
Mohamed et al[73]	2011	Egypt	100	50 HCC; 50 non-HCC; 20 non HCV	HOMA-IR and HCC	Univariate	No	NS
Diabetes mellitus/insulin resistance and development of HCC in HCV-infected patients
Chen et al[117]	2008	Taiwan	1095	-	DM and HCC	Multivariate	Yes	OR = 3.52 [1.29, 9.24]
Veldt et al[16]	2008	Europe	541		DM and HCC	Multivariate	Yes3	OR = 3.28 [1.35, 7.97]; P = 0.0093
Konishi et al[118]	2009	Japan	197	Non DM, treated for HCV	DM1 and HCC	Multivariate	Yes	HR = 4.63 [1.677, 12.766]; P = 0.003
Hung et al[14]	2010	Taiwan	1470	Treated for HCV	DM and HCC	Multivariate	Yes2	HR = 4.32 [1.23, 15.25]; P = 0.0232
Nkontchou et al[119]	2010	France	248	Cirrhotics	HOMA-IR and HCC	Multivariate	Yes	HR = 1.10 [1.01, 1.21]; P = 0.026
Takahashi et al[120]	2011	Japan	203	Non DM, treated for HCV	DM1 and HCC	Multivariate	Yes	HR = 6.9 [1.7, 28.4]; P < 0.05
Arase et al[121]	2013	Japan	4302	Non treated for HCV	DM and HCC	Multivariate	Yes	HR = 1.73 [1.3, 2.3]; P < 0.001
Elkrief et al[45]	2014	France	348	Cirrhotics	DM	Multivariate	Yes	HR = 1.938 [1.129 , 3.328]; P = 0.016
Toyoda et al[122]	2015	Japan	522	Patients with SVR	DM and HCC	Multivariate	Yes	HR = 2.08 [1.0170, 4.0133]; P = 0.045
Lai et al[123]	2006	Taiwan	2141	-	DM and HCC	Multivariate	No	NS
Chen et al[124]	2013	Taiwan	5186	-	DM and HCC	Multivariate	No	NS

¹Association of abnormal post-challenge hyperglycaemia and HCC;

²Only in SVR patients without cirrhosis;

³Only in advanced liver fibrosis. HCV: Hepatitis virus infection; HCC: Hepatocellular carcinoma; SVR: Sustained virological response; HOMA-IR: Homeostasis Model Assessment of Insulin Resistance; IR: Insulin resistance; DM: Diabetes mellitus; NS: Not significant.