Source Division of Liver Disease, Jinan Infectious Disease Hospital, Shandong University, Jinan, China.

Type 2 diabetes has been suggested as an independent risk factor for the development of hepatocellular carcinoma (HCC). However, the role of type 2 diabetes on the development of HCC in the presence of chronic hepatitis B (CHB) is still inconclusive. We conducted this hospital-based case-control study to evaluate the roles of type 2 diabetes in HCC development in patients with CHB. From January 2004 to December 2008, a total of 6275 eligible consecutive patients with chronic hepatitis B virus (HBV) infection were recruited. 1105 of them were patients with HBV-related HCC and 5,170 patients were CHB but without HCC. We used multivariate logistic regression models to investigate the association between type 2 diabetes and HCC risk. The prevalence of type 2 diabetes is higher among HCC patients without cirrhosis than among those with cirrhosis (12.1% vs. 6.7%, P=0.003). Type 2 diabetes was associated with a significantly high risk of HCC in female patients after adjusting for age, family history of HCC, city of residence, hepatitis B e antigen and cirrhosis with an odds ratio (95% confidence interval, CI) of 1.9 (1.1-3.4). Restricted analyses among female patients without cirrhosis indicated that type 2 diabetes was strongly associated with HCC risk with adjusted odds ratio (95%CI) of 5.6 (2.2-14.1). In conclusion, type 2 diabetes is independently associated with the increased risk of HCC in female CHB patients. Female CHB patients with type 2 diabetes are of a high HCC risk population and should be considered for HCC close surveillance program.