[Fasting serum glucose and subsequent liver cancer risk in a Korean prospective cohort].
OBJECTIVE
Chronic infections with hepatitis B or C and alcoholic cirrhosis are three well-known major risk factors for liver cancer. Diabetes has also been suggested as a potential risk factor. However, the findings of previous studies have been controversial in terms of the causal association. Therefore, the aim of this study was to evaluate the association between serum glucose levels and liver cancer development in a Korean cohort.


METHODS
Thirty-six liver cancer cases were identified in the Korean Multi-Center Cancer Cohort (KMCC). Baseline information on lifestyle characteristics was obtained via questionnaire. Serum glucose levels were measured at the study's enrollment. Relative risks (RRs) were estimated using a Cox proportional hazard regression model. The adjusting variables included age, gender, smoking history, alcohol consumption, body mass index, and hepatitis B surface antigen (HBsAg) seropositivity.


RESULTS
The RRs of serum glucose for liver cancer were 1.20 (95% CI = 0.48-2.99) for the category of 100 to 125 mg/dL of serum glucose and 2.77 (95% CI = 1.24-6.18) for the > 126 mg/dL serum glucose category (both compared to the < 100 mg/dL category). In a subgroup analysis, the RR of serum glucose among those who were both HBsAg seronegative and non-drinkers was 4.46 (95% CL = 1.09-18.28) for those with glucose levels > 100 mg/dL.


CONCLUSIONS
The results of this study suggest that a high level of serum glucose can increase liver cancer risk independently of hepatitis infection and drinking history in Koreans. This study implies that glucose intolerance may be an independent risk factor for liver cancer.
Gwack
Jin
J
Department of Preventive Medicine, Seoul National University College of Medicine.
Hwang
Seung-Sik
SS
Ko
Kwang-Pil
KP
Jun
Jae Kwan
JK
Park
Sue Kyung
SK
Chang
Soung-Hoon
SH
Shin
Hai-Rim
HR
Yoo
Keun-Young
KY
D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000453:epidemiology; D001786:Blood Glucose / Q000032:analysis*; D015331:Cohort Studies; D005215:Fasting; D005260:Female; D006509:Hepatitis B / Q000150:complications*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000276:immunology; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications*; D008113:Liver Neoplasms / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors
D001786:Blood Glucose; D006514:Hepatitis B Surface Antigens