Effect Of The Incidence Of Hepatocarcinoma In Chronic Hepatitis C Patients With Diabetes-a Meta-analysis

BackgroundCHC has become a global trend in the world,especially in some Asian regions,andHCV infection has the characteristics of chronicity and insidious onset,so if some patients can not find early and treatmentcan timely,the long-term effect of the virus can lead to liver fibrosis,livercirrhosis,and even hepatocarcinoma.Hepatitis C virus infection is also a risk factor of diabetes.DM is also a major risk factor for the infection of HCV.There is a clear interaction between the two factors.While impact of the combination of DM on the incidence of hepatocarcinoma in CHC patients is not yet clear.Effect of DM combined with CHC on the incidence of liver cancer is not clear.Therefore,whether CHC patients with DM affects the incidence of HCC has become a research hotspot.ObjectiveTo evaluate the effect of chronic hepatitis C(CHC)with diabetes mellitus(DM)on the incidence of hepatocarcinoma.MethodsThis study search literatures about effect of patients with CHC and DM incidence rate of HCC by CNKI,Wanfang database,CQVIP,Pubmed,Embase and other literature retrieval platform.Then conduct the literature selection,quality assessment,then included the literature in accordance with the standards of the cohort study.Then the documentscollected by 2 people were screened,and the quality of the literature was evaluated.The literature of high quality in the related research was obtained,and the data were extracted and analyzed.Accordingto the data extraction and statistics,this study select the random effects model.The combined effect of the amount is relative risk,and conduct sensitivity analysis,heterogeneity and publication bias detection,Stata13.0 is used in statistical analysis.ResultsA total of 9 cohort studies were selected,including 11855 CHC patients,1058 in group DM and 10797 in non DM group.The results show that the difference of DM group and non DM group of hepatocarcinoma incidence rate was statistically significant(RR=2.674,95%CI:1.800-3.974,P=0.000),there is a large heterogeneity(P=0.000,I~2=86.2%).Making a subgroup analysis according to whether the patients with cirrhosis:as research object for all patients with liver cirrhosis,the combined effect of the amount of the results were not statistically significant(95%CI:0.689-1.580,P=0.842),while heterogeneity decreased significantly(I~2=40.8%,P=0.194);while the subjects are not associated with liver cirrhosis,the combined effect of significant results(95%CI:2.341-6.101,P=0.000),heterogeneity also decreased significantly(I~2=42.2%,P=0.188).A relatively stable results by sensitivity analysis;the results of publication bias is in allowed band by Harbord(95%CI:-1.582823-10.18881,P=0.130)and Peters method(95%CI:-409.0079-382.1317,P=0.939).Conclusions1.In patients with CHC combined cirrhosis,there was no statistical difference in the effect of DM on the incidence of HCC;In simple patients with hepatitis C,combination of DM can increase the incidence of HCC,with a statistical difference.2.DM may affect the incidence of HCC by affecting the process of liver cirrhosis in patients with CHC.