title: Relationship between hepatocellular carcinoma and impaired glucose tolerance among Japanese.
abstract: OBJECTIVE
  Both the incidence of diabetes mellitus (DM) and mortality from Hepatocellular carcinoma (HCC) are increasing in Japan. As the association of overall cancer and HCC with impaired glucose tolerance (IGT) has been studied rarely in the world including Japan, this study assessed their associations using cohort data of Hokkaido, Japan.
  
  
  METHODS
  After getting ethical consent, this study included 908 men and 1,081 women aged 30-77 years during 1977-78 and collected detailed information using the baseline survey. The subjects were followed until 2002 and deaths were recorded using ICD-9. Classifying them into three groups of diabetes status namely DM, IGT, and normal, the relative risk (RR) of mortality was estimated by diabetes status using multivariate Cox model.
  
  
  RESULTS
  This study revealed no association between overall cancer and diabetes status. However, the RR of mortality from HCC was about 11 times (HR= 10.8, 95%CI: 1.3-92.5) higher in IGT compared with normal group. DM group also showed higher risk of mortality than normal group.
  
  
  CONCLUSIONS
  HCC mortality was significantly high among IGT group. However, as the results of the study were based on small data, further studies with large cohort are needed to address the association of IGT with overall cancer and HCC mortality in Japan.
authors.affiliation: Department of Public Health, Sapporo Medical University School of Medicine, Japan. khan@sapmed.ac.jp
authors.forename: M M H
authors.initials: MM
authors.lastname: Khan
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Saito
authors.forename: Satoru
authors.initials: S
authors.lastname: Takagi
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Ohnishi
authors.forename: Hisako
authors.initials: H
authors.lastname: Izumi
authors.forename: Fumio
authors.initials: F
authors.lastname: Sakauchi
authors.forename: Masakazu
authors.initials: M
authors.lastname: Washio
authors.forename: Tomoko
authors.initials: T
authors.lastname: Sonoda
authors.forename: Yoshie
authors.initials: Y
authors.lastname: Nagata
authors.forename: Sumiyo
authors.initials: S
authors.lastname: Asakura
authors.forename: Kota
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Mori
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Shimamoto
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D018149:Glucose Intolerance / Q000453:epidemiology*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality