Association of Dipeptidyl Peptidase-4 Inhibitors Use with Reduced Risk of Hepatocellular Carcinoma in Type 2 Diabetes Patients with Chronic HBV Infection
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Data Resource
2.2. Study Population
2.3. Definition of DPP4 Inhibitors Use and Comorbidities
2.4. Follow-Up to Newly Diagnosed HCC
2.5. Study Design
2.6. Statistical Analysis
3. Results
3.1. Baseline Characteristics
3.2. Incidence of HCC
3.3. Relative Risk of HCC with and without Treatment with DPP-4 Inhibitors
4. Discussion
The Limitations of Our Study
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | Before Propensity Score Matching | After Propensity Score Matching | ||||
---|---|---|---|---|---|---|
DPP-4 Inhibitors Use | Non-Use | p Value | DPP-4 Inhibitors Use | Non-Use | p Value | |
(N = 5514) | (N = 22,557) | (N = 5514) | (N = 5514) | |||
Age (Years) | ||||||
20–29 | 780 (14.15) | 3388 (15.02) | <0.0001 | 780 (14.15) | 779 (14.13) | - |
30–39 | 1679 (30.45) | 5571 (24.70) | 1679 (30.45) | 1679 (30.45) | ||
40–49 | 1789 (32.44) | 7365 (32.65) | 1789 (32.44) | 1789 (32.44) | ||
50–59 | 904 (16.39) | 4061 (18.00) | 904 (16.39) | 905 (16.41) | ||
60+ | 362 (6.57) | 2172 (9.63) | 362 (6.57) | 362 (6.57) | ||
Mean ± SD | 51.53 ± 11.24 | 52.65 ± 12.32 | <0.0001 | 51.53 ± 11.24 | 51.50 ± 11.51 | - |
Sex | ||||||
Female | 1886 (34.20) | 9726 (43.12) | <0.0001 | 1886 (34.20) | 1886 (34.20) | - |
Male | 3628 (65.80) | 12,831 (56.88) | 3628 (65.80) | 3628 (65.80) | ||
HCV infection | ||||||
No | 4981 (90.33) | 20,640 (91.50) | 0.0059 | 4981 (90.33) | 4981 (90.33) | - |
Yes | 533 (9.67) | 1917 (8.50) | 533 (9.67) | 533 (9.67) | ||
Cirrhosis | ||||||
No | 4695 (85.15) | 19,772 (87.65) | <0.0001 | 4695 (85.15) | 4695 (85.15) | - |
Yes | 819 (14.85) | 2785 (12.35) | 819 (14.85) | 819 (14.85) | ||
Anti-virus drug | ||||||
No | 4636 (84.08) | 19,867 (88.07) | <0.0001 | 4636 (84.08) | 4770 (86.51) | 0.0003 |
Yes | 878 (15.92) | 2690 (11.92) | 878 (15.92) | 744 (13.49) | ||
Insulin use | ||||||
No | 3976 (72.11) | 21,270 (94.29) | <0.0001 | 3976 (72.11) | 5160 (93.58) | <0.0001 |
Yes | 1538 (27.89) | 1287 (5.71) | 1538 (27.89) | 354 (6.42) | ||
HCC | ||||||
No | 5391 (97.77) | 21,848 (96.86) | 0.0003 | 5391 (97.77) | 5322 (96.52) | <0.0001 |
Yes | 123 (2.23) | 709 (3.14) | 123 (2.23) | 192 (3.48) | ||
Death | ||||||
No | 5116 (92.78) | 20,167 (89.40) | <0.0001 | 5116 (92.78) | 4910 (89.05) | <0.0001 |
Yes | 398 (7.22) | 2390 (10.60) | 398 (7.22) | 604 (10.95) |
Baseline Characteristics | Before Propensity Score Matching | After Propensity Score Matching | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
Number of Subjects (N = 28,071) | Number of HCC (N = 832) | Person-Years of Follow-Up | Incidence Rate † | p Value | Number of Subjects (N = 11,028) | Number of HCC (N = 315) | Person-Years of Follow-Up | Incidence Rate † | p Value | |
DPP-4 inhibitors | ||||||||||
No | 22,557 | 709 | 147,495 | 480.69 | 0.0003 | 5514 | 192 | 36,050 | 532.59 | <0.0001 |
Yes | 5514 | 123 | 38,044 | 323.31 | 5514 | 123 | 38,044 | 323.31 | ||
Age (Years) | ||||||||||
20–29 | 4168 | 21 | 28,598 | 73.43 | <0.0001 | 1559 | 10 | 10,728 | 93.21 | <0.0001 |
30–39 | 7250 | 128 | 49,054 | 260.94 | 3358 | 74 | 22,808 | 324.45 | ||
40–49 | 9154 | 287 | 61,187 | 469.05 | 3578 | 118 | 24,126 | 489.10 | ||
50–59 | 4965 | 254 | 32,220 | 788.33 | 1809 | 80 | 12,037 | 664.62 | ||
60+ | 2534 | 142 | 14,480 | 980.66 | 724 | 33 | 4394 | 751.02 | ||
Sex | ||||||||||
Female | 11,612 | 202 | 78,365 | 257.77 | <0.0001 | 3772 | 58 | 25,780 | 224.98 | <0.0001 |
Male | 16,459 | 630 | 107,174 | 587.83 | 7256 | 257 | 48,313 | 531.95 | ||
HCV infection | ||||||||||
No | 25,621 | 607 | 170,419 | 356.18 | <0.0001 | 9962 | 221 | 67,355 | 328.11 | <0.0001 |
Yes | 2450 | 225 | 15,119 | 1488.19 | 1066 | 94 | 6739 | 1394.87 | ||
Cirrhosis | ||||||||||
No | 24,467 | 178 | 166,015 | 107.22 | <0.0001 | 9390 | 60 | 64,571 | 92.92 | <0.0001 |
Yes | 3604 | 654 | 19,523 | 3349.89 | 1638 | 255 | 9523 | 2677.73 | ||
Anti-virus drug | ||||||||||
No | 24,503 | 411 | 163,978 | 250.64 | <0.0001 | 9406 | 140 | 63,909 | 219.06 | <0.0001 |
Yes | 3568 | 421 | 21,561 | 1952.60 | 1622 | 175 | 10,185 | 1718.21 | ||
Insulin | ||||||||||
No | 25,246 | 705 | 168,330 | 418.82 | <0.0001 | 9136 | 243 | 61,845 | 392.92 | <0.0001 |
Yes | 2825 | 127 | 17,209 | 737.99 | 1892 | 72 | 12,249 | 587.80 |
Characteristics | Before Propensity Score Matching | After Propensity Score Matching | ||
---|---|---|---|---|
Crude HR (95% CI) | Adjusted HR * (95% CI) | Crude HR (95% CI) | Adjusted HR * (95% CI) | |
DPP-4 inhibitors | ||||
No | Ref | Ref | Ref | Ref |
Yes | 0.68 (0.56–0.82) | 0.53 (0.44–0.65) | 0.61 (0.49–0.76) | 0.53 (0.42–0.68) |
Age (Years) | ||||
20–29 | Ref | Ref | Ref | Ref |
30–39 | 3.55 (2.24–5.63) | 2.43 (1.53–3.86) | 3.48 (1.80–6.74) | 2.76 (1.42–5.34) |
40–49 | 6.38 (4.09–9.93) | 4.01 (2.57–6.25) | 5.26 (2.76–10.02) | 3.90 (2.04–7.46) |
50–59 | 10.72 (6.87–16.72) | 5.69 (3.64–8.91) | 7.15 (3.71–13.80) | 5.26 (2.71–10.20) |
60+ | 13.25 (8.38–20.95) | 7.24 (4.56–11.50) | 8.04 (3.96–16.31) | 7.32 (3.58–14.96) |
Sex | ||||
Female | Ref | Ref | Ref | Ref |
Male | 2.28(1.95–2.67) | 1.88 (1.60–2.22) | 2.37 (1.78–3.15) | 2.13 (1.59–2.85) |
HCV infection | ||||
No | Ref | Ref | Ref | Ref |
Yes | 4.18 (3.59–4.87) | 2.11 (1.79–2.48) | 4.26 (3.35–5.43) | 2.25 (1.74–2.92) |
Cirrhosis | ||||
No | Ref | Ref | Ref | Ref |
Yes | 31.51 (26.70–37.20) | 16.82 (13.97–20.26) | 29.08 (21.95–38.54) | 15.78 (11.53–21.59) |
Anti-virus drug | ||||
No | Ref | Ref | Ref | Ref |
Yes | 7.80 (6.81–8.94) | 2.37 (2.03–2.76) | 7.87 (6.30–9.83) | 2.61 (2.03–3.35) |
Insulin use | ||||
No | Ref | Ref | Ref | Ref |
Yes | 1.78 (1.47–2.15) | 0.88 (0.72–1.07) | 1.51 (1.16–1.96) | 0.86 (0.65–1.14) |
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Chen, T.-I.; Lee, F.-J.; Hsu, W.-L.; Chen, Y.-C.; Chen, M. Association of Dipeptidyl Peptidase-4 Inhibitors Use with Reduced Risk of Hepatocellular Carcinoma in Type 2 Diabetes Patients with Chronic HBV Infection. Cancers 2023, 15, 1148. https://doi.org/10.3390/cancers15041148
Chen T-I, Lee F-J, Hsu W-L, Chen Y-C, Chen M. Association of Dipeptidyl Peptidase-4 Inhibitors Use with Reduced Risk of Hepatocellular Carcinoma in Type 2 Diabetes Patients with Chronic HBV Infection. Cancers. 2023; 15(4):1148. https://doi.org/10.3390/cancers15041148
Chicago/Turabian StyleChen, Tzu-I, Fu-Jen Lee, Wan-Lun Hsu, Yong-Chen Chen, and Mingchih Chen. 2023. "Association of Dipeptidyl Peptidase-4 Inhibitors Use with Reduced Risk of Hepatocellular Carcinoma in Type 2 Diabetes Patients with Chronic HBV Infection" Cancers 15, no. 4: 1148. https://doi.org/10.3390/cancers15041148