Frontiers in oncology · 2026
Metabolic comorbidities affect the survival of hepatitis B virus-related hepatocellular carcinoma in Chinese patients: a retrospective cohort study with propensity score matching.
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Zhou Zheng, Zheng Xiyan, Lin Zhiqun, Chen Xianqing, Xie Maoyun
Аннотация
OBJECTIVE: Recent literature has confirmed the roles of metabolic comorbidities as risk factors for the incidence of hepatocellular carcinoma (HCC). In China, most HCC cases are attributed to chronic hepatitis B virus (HBV). However, the relationships between metabolic comorbidities and the prognosis of Chinese patients with hepatitis B virus (HBV)-related HCC remain uncertain.
METHODS: A total of 164 patients with HBV-related HCC from eight hospitals affiliated with Sun Yat-sen University were enrolled in this cohort study from 2011 to 2021. The patients were divided into the MC group (metabolic comorbidities: at least one metabolic comorbidity from among type 2 diabetes mellitus (T2DM), hypertension, and low high-density lipoprotein (HDL) levels) and the NMC group (without these factors). In this manuscript, "MC" refers to metabolic comorbidity, rather than metabolic syndrome. Propensity score matching (PSM) and multivariate Cox regression were used to analyse overall survival (OS).
RESULTS: After PSM, 60 patients each in the MC and NMC groups were included in the study. Overall survival was significantly worse in the MC group than in the NMC group before and after PSM. T2DM was an independent risk factor for OS. T2DM, hypertension, and low HDL levels were independent risk factors for the presence of intrahepatic multifocal lesions at diagnosis. The presence of all three metabolic comorbidities was associated with significantly worse OS (p=0.043).
CONCLUSION: Metabolic comorbidities were associated with poor prognosis and the progression of HBV-related HCC. The presence of three metabolic comorbidities (T2DM, hypertension, and low HDL levels) was associated with poor OS, suggesting that metabolic burden may negatively affect survival once a certain number of factors accumulate.
METHODS: A total of 164 patients with HBV-related HCC from eight hospitals affiliated with Sun Yat-sen University were enrolled in this cohort study from 2011 to 2021. The patients were divided into the MC group (metabolic comorbidities: at least one metabolic comorbidity from among type 2 diabetes mellitus (T2DM), hypertension, and low high-density lipoprotein (HDL) levels) and the NMC group (without these factors). In this manuscript, "MC" refers to metabolic comorbidity, rather than metabolic syndrome. Propensity score matching (PSM) and multivariate Cox regression were used to analyse overall survival (OS).
RESULTS: After PSM, 60 patients each in the MC and NMC groups were included in the study. Overall survival was significantly worse in the MC group than in the NMC group before and after PSM. T2DM was an independent risk factor for OS. T2DM, hypertension, and low HDL levels were independent risk factors for the presence of intrahepatic multifocal lesions at diagnosis. The presence of all three metabolic comorbidities was associated with significantly worse OS (p=0.043).
CONCLUSION: Metabolic comorbidities were associated with poor prognosis and the progression of HBV-related HCC. The presence of three metabolic comorbidities (T2DM, hypertension, and low HDL levels) was associated with poor OS, suggesting that metabolic burden may negatively affect survival once a certain number of factors accumulate.