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J Prev Med Public Health > Volume 40(1); 2007 > Article
Journal of Preventive Medicine and Public Health 2007;40(1): 23-28. doi: https://doi.org/10.3961/jpmph.2007.40.1.23
Fasting Serum Glucose and Subsequent Liver Cancer Risk in a Korean Prospective Cohort.
Jin Gwack, Seung Sik Hwang, Kwang Pil Ko, Jae Kwan Jun, Sue Kyung Park, Soung Hoon Chang, Hai Rim Shin, Keun Young Yoo
1Department of Preventive Medicine, Seoul National University College of Medicine, Korea. kyyoo@plaza.snu.ac.kr
2Research Institute for National Cancer Control and Evaluation, National Cancer Center, Korea.
3Department of Preventive Medicine, Konkuk University College of Medicine, Korea.
4National Cancer Center, Korea.
OBJECTIVES: Chronic infections with hepatitis B or C and alcoholic cirrhosis are three well-known major risk factors for liver cancer. Diabetes has also been suggested as a potential risk factor. However, the findings of previous studies have been controversial in terms of the causal association. Therefore, the aim of this study was to evaluate the association between serum glucose levels and liver cancer development in a Korean cohort. METHODS: Thirty-six liver cancer cases were identified in the Korean Multi-Center Cancer Cohort (KMCC). Baseline information on lifestyle characteristics was obtained via questionnaire. Serum glucose levels were measured at the study's enrollment. Relative risks (RRs) were estimated using a Cox proportional hazard regression model. The adjusting variables included age, gender, smoking history, alcohol consumption, body mass index, and hepatitis B surface antigen (HBsAg) seropositivity. RESULTS: The RRs of serum glucose for liver caner were 1.20 (95% CI=0.48-2.99) for the category of 100 to 125 mg/dL of serum glucose and 2.77 (95% CI=1.24-6.18) for the >126 mg/dL serum glucose category (both compared to the <100 mg/dL category). In a subgroup analysis, the RR of serum glucose among those who were both HBsAg seronegative and non-drinkers was 4.46 (95% CI=1.09-18.28) for those with glucose levels >100 mg/dL. CONCLUSIONS: The results of this study suggest that a high level of serum glucose can increase liver cancer risk independently of hepatitis infection and drinking history in Koreans. This study implies that glucose intolerance may be an independent risk factor for liver cancer.
Key words: Liver neoplasms; Diabetes mellitus; Blood glucose; Cohort studies; Korea
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