Journal Article

The association between alcohol consumption and the risk of hepatocellular carcinoma according to glycemic status in Korea: A nationwide population-based study

Su Jong Yu, Kyungdo Han, Dong Wook Shin, Yoon Jun Kim, Eun Ju Cho, Jeong-Ju Yoo, Jung-Hwan Yoon, Yuri Cho, Goh Eun Chung

2023

Overview

Alcohol and diabetes are known risk factors for hepatocellular carcinoma (HCC); however, it is unclear whether the association between alcohol consumption and HCC risk differs by fasting serum glucose level and diabetes. We investigated the dose-response relationship between alcohol consumption and the risk of HCC according to glycemic status. This population-based observational cohort study included patients who underwent general health checkups in 2009 using the Korean National Health Insurance Service Database. The primary outcome was HCC incidence, and Cox proportional hazard regression analysis was performed to estimate the relationship between alcohol consumption and HCC risk according to glycemic status. A total of 34,321 patients newly diagnosed with HCC were observed in the median follow-up period of 8.3 years. In the multivariable model, we adjusted for age, sex, smoking, regular exercise, income, hypertension, dyslipidemia, and body mass index. Mild-to-moderate alcohol consumption increased the risk of HCC in all glycemic statuses (normoglycemia: hazard ratio [HR], 1.06; 95% confidence interval [CI], 1.02 to 1.10; prediabetes: HR, 1.19; 95% CI, 1.14 to 1.24; and diabetes: HR, 2.02; 95% CI, 1.93 to 2.11) compared to normoglycemic nondrinking. Heavy alcohol consumption also increased the risk of HCC in all glycemic statuses (normoglycemia: HR, 1.39; 95% CI, 1.32 to 1.46; prediabetes: HR, 1.67; 95% CI, 1.58 to 1.77; and diabetes: HR, 3.29; 95% CI, 3.11 to 3.49) compared to normoglycemic nondrinking. Since alcohol consumption information in this study was based on a self-administered questionnaire, there may be a possibility of underestimation. Although we excluded patients with a history of viral hepatitis using diagnosis codes, we could not obtain information on hepatitis B or hepatitis C serum markers. Both mild-to-moderate and heavy alcohol consumption was associated with an increased risk of HCC in all glycemic statuses. The increased risk of HCC according to alcohol consumption was the highest in the diabetes group, suggesting that more intensive alcohol abstinence is required for patients with diabetes.

• Publisher: Public Library of Science (PLoS),Public Library of Science
• Subject: Abstinence / Alcohol Drinking / Alcohol use / Analysis / Biology and Life Sciences / Blood sugar / Body mass index / Carcinoma, Hepatocellular / Cohort analysis / Confidence intervals / Diabetes / Diabetes mellitus / Diabetics / Dose-response relationship / Dose-response relationship (Biochemistry) / Drinking of alcoholic beverages / Drug dosages / Dyslipidemia / Fasting / Glucose / Glucose tolerance tests / Health aspects / Health insurance industry / Hepatitis / Hepatitis B / Hepatitis C / Hepatocellular carcinoma / Hepatoma / Humans / Laboratories / Liver cancer / Liver cirrhosis / Liver diseases / Liver Neoplasms / Medical research / Medical screening / Medicine / Medicine and Health Sciences / Medicine, Experimental / Metabolic disorders / National health insurance / Physical Sciences / Population / Population studies / Population-based studies / Prediabetic State / Prevention / Questionnaires / R / Republic of Korea / Research Article / Review boards / Risk factors / Sociodemographics