Association of Type II Diabetes Mellitus with Hepatocellular Carcinoma Occurrence - a Case Control Study from Kathmandu Valley

Objective: To assess associations of Type II DM with hepatocellular carcinoma occurrence in Nepal. Materials and Methods: This case control study was carried out using data retrieved from the register maintained in the Department of Biochemistry of Nepalese Army Institute of Health Sciences between 1st January, 2012, and 31st August, 2012. The variables collected were age, gender, HbA1c. All biochemical parameters were analyzed in the Central Laboratory of our hospital by standard validated methods. One way ANOVA was used to examine the statistical significant difference between groups with the LSD post-hoc test for comparison of means of case groups. Odds ratios (OR) were calculated using simple logistic-regression analysis. Results: Etiological factors for HCC were HBV, HCV, alcohol and cryptogenic cirrhosis. The highest age group belonged to the etiological category of HCV with a mean of $71.9{\pm}3.6$ (CI 69.3, 74.5) years and the lowest age group to the etiological category of HBV with $61.7{\pm}5.3$(CI 57.9, 65.5) years. The main imperative basis of HCC in present study was HCV (39.5%) and second most significant cause of HCC was alcohol (26%). Glycated hemoglobin was found to be more in males with HCC (7.9%) as compared to females (7.3%). The percentage of Type II diabetes mellitus was greater in HCC patients when compared to controls. This difference was statistically significant with an odd ratio of 4.63 (p<0.001). Conclusion: Type II DM influences incidence, risk of recurrence, overall survival, and treatment-related complications in HCC patients.