Incidence and risk factors for hypoglycemia in patients with hepatocellular carcinoma

Zheng, Xiaoyun; Yan, Hong‐Hong; Gan, Bin; Qiu, Xiaoting; Qiu, Jie; Zhang, Jing; Chen, Xiaoming; Huang, Cuijuan; Xiumei, Chen

doi:10.21203/rs.3.rs-905429/v1

Cited by 2 publications

(1 citation statement)

References 10 publications

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“…Nonetheless, hypoglycemia is more likely to develop in massive hepatocytes necrosis. A study in China suggested that Child-Pugh grade C, higher AFP, and low HbA1c significantly increase the likelihood of hypoglycemia in the population (Zheng et al, 2021). In this case, the absence of chronic liver disease stigmata with a normal albumin and coagulation blood test have put the patient in a compensated liver state.…”

Section: Discussionmentioning

confidence: 99%

Approach to Refractory Hypoglycaemia in a Patient with Hepatocellular Carcinoma: A Case Study and Literature Review

Ariana,

Permadi,

Susanto

2024

AMS

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Symptomatic hypoglycaemia in patients without underlying diabetes is uncommon. Etiology of non-diabetic hypoglycaemia varies from hyperinsulinism, hormone deficiencies, malignancies, to critical illness. This case report illustrates the attempt to determine the cause of refractory hypoglycaemia in a 46 years old male patient with underlying hepatocellular carcinoma (HCC). Anamnesis and examinations have narrowed differential diagnosis to concurrent systemic illness (liver failure due to HCC) or paraneoplastic syndrome from non-beta cell tumors, referred as non-islet cell tumor hypoglycaemia (NICTH). It was noted that the absence of chronic liver disease stigmata has put NICTH as the possible main cause. Deciding what diagnostic modalities needed to perform to establish the diagnosis eventually relies on clinical judgement while taking cost-effectiveness and patients’ preference in consideration, particularly in low-resource settings. Nonetheless, the main goal of treating hypoglycaemia is to immediately achieve and sustain euglycemia which can be achieved conservatively or definitively with surgery despite the etiology. Keywords: Hepatocellular carcinoma, Hypoglycaemia, NICTH.

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Section: Discussionmentioning

confidence: 99%

Approach to Refractory Hypoglycaemia in a Patient with Hepatocellular Carcinoma: A Case Study and Literature Review

Ariana,

Permadi,

Susanto

2024

AMS

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Impact of Hypoglycemia on Hospitalized Patients With Hepatocellular Carcinoma

Iqbal,

Solipuram,

Mohammed

et al. 2024

Cureus

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Aims Hepatocellular carcinoma (HCC) is one of the common liver malignancies that presents a challenge to global healthcare. The impact and outcomes of hypoglycemia in HCC have not been studied in detail before. This study aimed to investigate the outcomes and prognosis associated with hypoglycemia in patients diagnosed with HCC, utilizing a large-scale database approach. Methods Using the Nationwide Inpatient Sample (NIS) database from 2017 to 2020, we conducted a comprehensive retrospective analysis to examine the incidence, risk factors, and clinical implications of hypoglycemia on HCC patients. The patients were divided into two groups: those with hypoglycemia and those without hypoglycemia. Univariate and multivariate logistic regression were used to conduct the analysis. STATA® version 17.0 software (StataCorp LLC, College Station, TX) was used for this purpose. Results Out of a total of 343,895 patients with HCC, the prevalence of hypoglycemia was present in 1.5% of this patient population. We found that hypoglycemia was common in the male population (68%). Compared with patients without hypoglycemia, patients who had hypoglycemia with HCC had higher mortality (42%, p-value < 0.05) and higher risks of secondary outcomes such as hepatic failure, spontaneous bacterial peritonitis (SBP), ascites, and portal vein thrombosis compared to patients who did not have hypoglycemia. The multivariate-adjusted odds ratio for hepatic failure was 2.7 (2.3-3.1), for SBP was 2.9 (1.8-3.0), for ascites was 1.6 (1.4-1.9), and for portal vein thrombosis was 1.2 (0.9-1.4). Conclusion In conclusion, hypoglycemia in HCC is associated with increased mortality and worse outcomes.

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Incidence and risk factors for hypoglycemia in patients with hepatocellular carcinoma

Cited by 2 publications

References 10 publications

Approach to Refractory Hypoglycaemia in a Patient with Hepatocellular Carcinoma: A Case Study and Literature Review

Approach to Refractory Hypoglycaemia in a Patient with Hepatocellular Carcinoma: A Case Study and Literature Review

Impact of Hypoglycemia on Hospitalized Patients With Hepatocellular Carcinoma

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