Thiazolidinediones, alpha-glucosidase inhibitors, meglitinides, sulfonylureas, and hepatocellular carcinoma risk: A meta-analysis.
Thiazolidinediones, alpha-glucosidase inhibitors, meglitinides, sulfonylureas, and hepatocellular carcinoma risk: A meta-analysis.
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DOI：
10.1016/j.metabol.2021.154780
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发表时间：
2021-07
期刊：
影响因子：
--
通讯作者：
Simon TG
中科院分区：
文献类型：
--
作者：
Arvind A;Memel ZN;Philpotts LL;Zheng H;Corey KE;Simon TG
肝细胞癌（HCC）仍然是全球癌症相关死亡的主要原因。二线口服抗糖尿病药物对 2 型糖尿病患者发生 HCC 风险的影响尚不清楚。本研究评估了磺酰脲类、噻唑烷二酮类、美格列奈类和 α-葡萄糖苷酶抑制剂与 HCC 风险之间的关联。我们系统地回顾了 PubMed、Embase 和 Web of Science 数据库的所有研究。如果研究记录了以下情况，则纳入研究：(1) 接触口服抗糖尿病药物类别； (2) 肝癌发病率； (3) HCC 发病率的相对风险/比值比 (OR)。确定了八项合格的观察性研究。我们进行了随机效应荟萃分析来计算汇总调整 OR (aOR) 和 95% 置信区间 (CI)。噻唑烷二酮的使用（7项研究，280,567名受试者，19,242例HCC病例）与HCC风险降低相关（aOR=0.92，95% CI=0.86-0.97，I2=43%），包括亚洲受试者（aOR=0.90，95% CI=0.83-0.97），但与西方受试者无关（aOR=0.95， 95% CI=0.87-1.04）。 α-葡萄糖苷酶抑制剂的使用（3项研究，56,791名受试者，11,069例HCC病例）与HCC发病率增加相关（aOR=1.08；95% CI=1.02-1.14，I2=21%）。在包括已确诊肝病患者在内的研究中，磺酰脲类药物的使用（8项研究，281,180名受试者，19,466例HCC病例）与HCC风险增加相关（aOR=1.06，95% CI=1.02-1.11，I2=75%）。美格列奈的使用（4 项研究，58,237 名受试者，11,310 例 HCC 病例）与 HCC 发病率无关（aOR=1.19；95% CI=0.89-1.60，I2=72%）。噻唑烷二酮的使用与亚洲糖尿病患者的 HCC 发病率降低有关。 α-葡萄糖苷酶抑制剂或磺酰脲类药物的使用与 HCC 风险适度增加有关；未来的研究应确定慢性肝病患者是否应避免使用这些药物。
Hepatocellular carcinoma (HCC) remains a leading cause of cancer-related death worldwide. Effects of second-line oral antidiabetic medications on incident HCC risk in individuals with type 2 diabetes mellitus remain unclear. This study evaluated associations between sulfonylureas, thiazolidinediones, meglitinides and alpha-glucosidase inhibitors, and incident HCC risk. We systematically reviewed all studies on PubMed, Embase and Web of Science databases. Studies were included if they documented: (1) exposure to oral antidiabetic medication classes; (2) HCC incidence; (3) relative risks/odds ratios (OR) for HCC incidence. Eight eligible observational studies were identified. We performed random-effects meta-analyses to calculate pooled adjusted ORs (aORs) and 95% confidence intervals (CI). Thiazolidinedione use (7 studies, 280,567 participants, 19,242 HCC cases) was associated with reduced HCC risk (aOR=0.92, 95% CI=0.86-0.97, I2=43%), including among Asian subjects (aOR=0.90, 95% CI=0.83-0.97), but not Western subjects (aOR=0.95, 95% CI=0.87-1.04). Alpha-glucosidase inhibitor use (3 studies, 56,791 participants, 11,069 HCC cases) was associated with increased HCC incidence (aOR=1.08; 95% CI=1.02-1.14, I2=21%). Sulfonylurea use (8 studies, 281,180 participants, 19,466 HCC cases) was associated with increased HCC risk in studies including patients with established liver disease (aOR=1.06, 95% CI=1.02-1.11, I2=75%). Meglitinide use (4 studies, 58,237 participants, 11,310 HCC cases) was not associated with HCC incidence (aOR=1.19; 95% CI=0.89-1.60, I2=72%). Thiazolidinedione use was associated with reduced HCC incidence in Asian individuals with diabetes. Alpha-glucosidase inhibitor or sulfonylurea use was associated with modestly increased HCC risk; future research should determine whether those agents should be avoided in patients with chronic liver disease.
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影响因子：
9.7
作者：
Arnold, Suzanne V.;Inzucchi, Silvio E.;Kosiborod, Mikhail
通讯作者：
Kosiborod, Mikhail
影响因子：
24.5
作者：
Chen, Hsiao-Ping;Shieh, Jeng-Jer;Wu, Chun-Ying
通讯作者：
Wu, Chun-Ying
影响因子：
5.8
作者：
Chang, Chia-Hsuin;Lin, Jou-Wei;Chuang, Lee-Ming
通讯作者：
Chuang, Lee-Ming
血糖浓度和肝癌的风险：前瞻性研究的系统评价和荟萃分析。
影响因子：
--
作者：
Han H;Zhang T;Jin Z;Guo H;Wei X;Liu Y;Chen Q;He J
通讯作者：
He J
影响因子：
3.7
作者：
Gu Y;Wang C;Zheng Y;Hou X;Mo Y;Yu W;Zhang L;Hu C;Nan H;Chen L;Li J;Liu Y;Huang Z;Han M;Bao Y;Zhong W;Jia W
通讯作者：
Jia W