Association between cancer prevalence and use of thiazolidinediones: results from the Vermont Diabetes Information System.
Association between cancer prevalence and use of thiazolidinediones: results from the Vermont Diabetes Information System.
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DOI：
10.1186/1741-7015-5-17
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发表时间：
2007-06-21
期刊：
影响因子：
9.3
通讯作者：
Littenberg B
中科院分区：
文献类型：
--
作者：
Ramos-Nino ME;MacLean CD;Littenberg B
过氧化物酶体增殖物激活受体（PPARs）已成为糖尿病的重要药物靶点。激活PPARγ的药物，如噻唑烷二酮类（TZD），广泛用于治疗2型糖尿病。在几种体外模型中，过氧化物酶体增殖物激活受体γ信号也可以发挥抗肿瘤作用，尽管体内模型报告了相互矛盾的结果。TZDs对人类癌症风险的影响需要解决，因为这些药物在糖尿病患者中的处方时间很长。共有1003名受试者在社区实践环境中进行了采访，在家里的时间登记进入佛蒙特州糖尿病信息系统，临床决策支持计划。患者自我报告其个人和临床特征，包括任何恶性肿瘤史。实验室数据直接从临床实验室获得，当前药物通过直接观察药物容器获得。我们对受访者进行了横断面分析，以评估癌症诊断和TZD使用之间可能存在的关联。在多变量logistic回归模型中，癌症的诊断与TZD的使用显著相关，即使校正了潜在的混杂因素，包括其他口服降糖药（磺脲类和双胍类）、年龄、糖化血红蛋白A1C、体重指数、吸烟、高合并症和处方药数量（比值比= 1.59，P = 0.04）。这种关联在使用罗格列酮的患者（OR = 1.89，P = 0.02）和女性患者（OR = 2.07，P = 0.01）中尤为明显。这些数据表明TZD使用与糖尿病患者的癌症之间存在关联。需要进一步的研究来确定这种关联是否是因果关系。
Peroxisome proliferator-activated receptors (PPARs) have emerged as important drug targets for diabetes. Drugs that activate PPARγ, such as the thiazolidinediones (TZDs), are widely used for treatment of Type 2 diabetes mellitus. PPARγ signaling could also play an anti-neoplastic role in several in vitro models, although conflicting results are reported from in vivo models. The effects of TZDs on cancer risk in humans needs to be resolved as these drugs are prescribed for long periods of time in patients with diabetes. A total of 1003 subjects in community practice settings were interviewed at home at the time of enrolment into the Vermont Diabetes Information System, a clinical decision support program. Patients self-reported their personal and clinical characteristics, including any history of malignancy. Laboratory data were obtained directly from the clinical laboratory and current medications were obtained by direct observation of medication containers. We performed a cross-sectional analysis of the interviewed subjects to assess a possible association between cancer diagnosis and the use of TZDs. In a multivariate logistic regression model, a diagnosis of cancer was significantly associated with TZD use, even after correcting for potential confounders including other oral anti-diabetic agents (sulfonylureas and biguanides), age, glycosylated hemoglobin A1C, body mass index, cigarette smoking, high comorbidity, and number of prescription medications (odds ratio = 1.59, P = 0.04). This association was particularly strong among patients using rosiglitazone (OR = 1.89, P = 0.02), and among women (OR = 2.07, P = 0.01). These data suggest an association between TZD use and cancer in patients with diabetes. Further studies are required to determine if this association is causal.
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影响因子：
3.6
作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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作者：
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通讯作者：
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作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
Gouerou, Herve