Insulin Resistance Tied to Hepatocellular Carcinoma Risk in Chronic Hepatitis B

HealthDay News — Insulin resistance assessed by homeostasis model assessment index (HOMA2-IR) correlates with the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B virus (HBV) infection, according to a study published in the Journal of Gastroenterology and Hepatology.

Jung Hee Kim, from the Sungkyunkwan University School of Medicine in Seoul, South Korea, and colleagues examined whether HOMA2-IR can stratify HCC risk in a retrospective cohort of 1696 patients with chronic HBV.

The researchers found that 1.4% of patients developed HCC. The incidence rate of HCC was higher for patients with higher vs lower HOMA2-IR values (1.7% vs 0.5% for HOMA2-IR >1.200 vs ≤1.200; P =.009). 

In a multivariable model adjusted for age, sex, cirrhosis, and HBV DNA levels, HOMA2-IR was a significant factor associated with HCC development (hazard ratio [HR]: 3.25; 95% confidence interval [CI], 1.13-9.31). The correlation was attenuated after further adjustment for obesity, hypertension, and diabetes (HR: 1.93; 95% CI, 0.57-6.51). 

In patients without overt metabolic abnormalities (hypertension, diabetes, and metabolic syndrome), but not in those with overt metabolic abnormalities, HOMA2-IR was an independent factor associated with HCC.

“HOMA2-IR was associated with the risk of HCC, indicating that HOMA2-IR can be a useful tool for stratifying the risk of HCC in chronic HBV-infected patients, particularly in patients without overt metabolic abnormalities,” the researchers wrote.

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  1. Kim JH, Sinn DH, Gwak G-Y, et al. Insulin resistance assessment is useful in risk stratification of hepatocellular carcinoma in chronic hepatitis B patients. J Gastroenterol Hepatol. 2016 Nov 11. doi:10.1111/jgh.13647.