Association of metformin intake with bladder cancer risk and oncologic outcomes in type 2 diabetes mellitus patients: A systematic review and meta-analysis.
Association of metformin intake with bladder cancer risk and oncologic outcomes in type 2 diabetes mellitus patients: A systematic review and meta-analysis.
复制标题
二甲双胍摄入量与 2 型糖尿病患者膀胱癌风险和肿瘤结果的关联：系统评价和荟萃分析
DOI：
10.1097/md.0000000000011596
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发表时间：
2018-07
期刊：
影响因子：
1.6
通讯作者：
Zu XB
中科院分区：
文献类型：
--
作者：
Hu J;Chen JB;Cui Y;Zhu YW;Ren WB;Zhou X;Liu LF;Chen HQ;Zu XB
补充数字内容可在文本中获得最近的临床试验表明，二甲双胍摄入量可能在各种癌症的发病率和肿瘤学结果中发挥保护作用。然而，其对膀胱癌的保护作用仍然不确定。我们进行了一项荟萃分析，以调查二甲双胍摄入量与糖尿病（DM）患者膀胱癌风险以及肿瘤学结局之间的关系。2017年12月，使用PubMed、Embase和科克伦中央检索库进行了全面的文献检索。合并风险比（HR）和95%置信区间（CI）。共纳入了9项回顾性队列研究，包括1，270，179例患者。一项荟萃分析显示，二甲双胍摄入与无复发生存期增加（HR = 0.55，95%置信区间[CI]= 0.35-0.88; P = 0.01; I2 = 64%）、无进展生存期改善（HR = 0.70，95% CI = 0.51-0.96; P = 0.03; I2 = 33%）和癌症特异性生存期延长（HR = 0.57，95% CI = 0.40-0.81; P = 0.002; I2 = 0%）相关。 然而，结果表明，二甲双胍摄入与膀胱癌发病率降低（HR = 0.82，95% CI = 0.61-1.09; P = 0.17; I2 = 85%）或膀胱癌患者总生存率增加（HR = 0.83，95% CI = 0.47-1.44; P = 0.50; I2 = 64%）无关。 目前的荟萃分析表明，二甲双胍摄入量可以改善膀胱癌患者的预后。仍需要进一步的前瞻性队列研究和机制研究来确定二甲双胍在膀胱癌发生和进展中的确切作用。
Supplemental Digital Content is available in the text Recent clinical trials indicated that metformin intake might play a protective role in the incidence and oncologic outcomes of various cancers. However, its protective effect on bladder cancer remains uncertain. We performed a meta-analysis to investigate the association between metformin intake and bladder cancer risk as well as oncologic outcomes in diabetes mellitus (DM) patients. A comprehensive literature search was performed using PubMed, Embase, and the Cochrane Central Search Library in December 2017. Hazard ratio (HR) with 95% confidence interval (CI) was pooled. A total of 9 retrospective cohort studies with 1,270,179 patients were included. A meta-analysis revealed that metformin intake was associated with an increased recurrence-free survival (HR = 0.55, 95% confidence interval [CI] = 0.35–0.88; P = .01; I2 = 64%), improved progression-free survival (HR = 0.70, 95% CI = 0.51–0.96; P = .03; I2 = 33%), and prolonged cancer-specific survival (HR = 0.57, 95% CI = 0.40–0.81; P = .002; I2 = 0%). However, results demonstrated that metformin intake was not associated with a decreased incidence of bladder cancer (HR = 0.82, 95% CI = 0.61–1.09; P = .17; I2 = 85%) or an increased overall survival in bladder cancer patients (HR = 0.83, 95% CI = 0.47–1.44; P = .50; I2 = 64%). The present meta-analysis indicated that metformin intake could improve the prognosis of bladder cancer patients. Further prospective cohort studies and mechanistic studies are still required to determine the precise role of metformin in the initiation and progression of bladder cancer.