Metformin therapy and risk of colorectal adenomas and colorectal cancer in type 2 diabetes mellitus patients: A systematic review and meta-analysis.
Metformin therapy and risk of colorectal adenomas and colorectal cancer in type 2 diabetes mellitus patients: A systematic review and meta-analysis.
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二甲双胍治疗与 2 型糖尿病患者结直肠腺瘤和结直肠癌的风险：系统评价和荟萃分析
DOI：
10.18632/oncotarget.13762
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发表时间：
2017-02-28
期刊：
影响因子：
--
通讯作者：
Xiang H
中科院分区：
文献类型：
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作者：
Liu F;Yan L;Wang Z;Lu Y;Chu Y;Li X;Liu Y;Rui D;Nie S;Xiang H
最近的证据表明，二甲双胍治疗可能与2型糖尿病患者结肠腺瘤/结直肠癌风险降低有关。然而，结果并不一致。因此，我们进行了一项系统回顾和荟萃分析，以评估二甲双胍治疗与2型糖尿病患者结直肠腺瘤/结直肠癌风险之间的关系。我们检索了2016年8月31日之前发表的文献：PubMed、Embase、CNKI和VIP中国期刊库。使用随机效应模型获得总风险估计（调整OR/调整RR/调整HR）及其95%置信区间（95% CI）。在结直肠腺瘤或结直肠癌发病率方面，选取了20项研究（包括12项队列研究、7项病例对照研究和1项随机对照试验研究）。二甲双胍治疗与结直肠腺瘤发生率降低相关（未经校正OR=0.80, 95% CI: 0.71-0.90, p=0.0002）。当对调整后的数据进行分析时，结直肠腺瘤风险的总估计降低至25%（调整后OR=0.75, 95% CI: 0.59-0.97, p=0.03）。此外，还观察到结直肠癌风险显著降低（未经调整OR=0.73, 95% CI: 0.62-0.86, p=0.0002）。对调整后的数据进行分析时，与未使用二甲双胍和其他治疗方法的患者相比，使用二甲双胍的患者患结直肠癌的风险降低了22%（调整后OR=0.78, 95% CI: 0.70-0.87, p<0.00001）。我们的荟萃分析表明，二甲双胍治疗可能与2型糖尿病患者结直肠腺瘤和结直肠癌的风险降低有关。
Recent evidence indicates that metformin therapy may be associated with a decreased colorectal adenoma/colorectal cancer risk in type 2 diabetes patients. However, results are not consistent. We therefore performed a systematic review and meta-analysis to assess the association between metformin therapy and risk of colorectal adenomas/colorectal cancer in type 2 diabetes mellitus patients. We searched the literature published before Aug 31, 2016 in four databases: PubMed, Embase database, CNKI and VIP Library of Chinese Journal. Summary risk estimates (adjusted OR/adjusted RR/adjusted HR) with their 95% confidence interval (95% CI) were obtained using a random effects model. Twenty studies (including 12 cohort studies, 7 case-control studies and 1 randomized controlled trial study) were selected in terms of data of colorectal adenomas or colorectal cancer incidence. Metformin therapy was found to be associated with a decreased incidence of colorectal adenomas (unadjusted OR=0.80, 95% CI: 0.71-0.90, p=0.0002). When the adjusted data were analyzed, the summary estimate decreased to 25% reduction in colorectal adenomas risk (adjusted OR=0.75, 95% CI: 0.59-0.97, p=0.03). Besides, a significant reduction of colorectal cancer risk was also observed (unadjusted OR=0.73, 95% CI: 0.62-0.86, p=0.0002). And when the adjusted data were analyzed, colorectal cancer risk for metformin users was decreased with a reduction of 22%, compared with non-metformin users and other treatment users (adjusted OR=0.78, 95% CI: 0.70–0.87, p<0.00001). Our meta-analysis suggested that metformin therapy may be associated with a decreased risk of colorectal adenomas and colorectal cancer in type 2 diabetes mellitus patients.