New users of metformin are at low risk of incident cancer: a cohort study among people with type 2 diabetes.
New users of metformin are at low risk of incident cancer: a cohort study among people with type 2 diabetes.
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DOI：
10.2337/dc08-2175
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发表时间：
2009-09
期刊：
影响因子：
16.2
通讯作者：
Evans JM
中科院分区：
文献类型：
--
作者：
Libby G;Donnelly LA;Donnan PT;Alessi DR;Morris AD;Evans JM
二甲双胍的抗糖尿病作用是通过激活AMP激活的蛋白激酶(AMPK)来实现的。AMPK的激活除了可以降低血糖水平外，还可以抑制肿瘤的形成和细胞生长。我们测试了二甲双胍降低2型糖尿病患者癌症风险的假设。在一项使用记录关联数据库的观察性队列研究中，我们在英国苏格兰的泰赛德进行了一项研究，确定了1994-2003年新使用二甲双胍的2型糖尿病患者。我们还确定了一组糖尿病对照者，根据糖尿病诊断年份分别与二甲双胍使用者匹配，这些人从未使用过二甲双胍。在生存分析中，我们计算了癌症诊断的风险比，并使用COX回归对两组的基线特征进行了调整。在4,085名二甲双胍使用者中，7.3%的人被诊断为癌症，而在4,085名参照者中，这一比例为11.6%，中位癌症发生时间分别为3.5年和2.6年(P<；0.001)。未调整的癌症风险比(95%CI)为0.46(0.40~0.53)。在调整了性别、年龄、BMI、A1C、剥夺、吸烟和其他药物使用后，与二甲双胍相关的癌症风险仍然显著降低：0.63(0.53-0.75)。这些结果表明，二甲双胍的使用可能与癌症风险的降低有关。需要一项随机试验来评估二甲双胍在癌症高危人群中是否具有保护作用。
The antidiabetic properties of metformin are mediated through its ability to activate the AMP-activated protein kinase (AMPK). Activation of AMPK can suppress tumor formation and inhibit cell growth in addition to lowering blood glucose levels. We tested the hypothesis that metformin reduces the risk of cancer in people with type 2 diabetes. In an observational cohort study using record-linkage databases and based in Tayside, Scotland, U.K., we identified people with type 2 diabetes who were new users of metformin in 1994–2003. We also identified a set of diabetic comparators, individually matched to the metformin users by year of diabetes diagnosis, who had never used metformin. In a survival analysis we calculated hazard ratios for diagnosis of cancer, adjusted for baseline characteristics of the two groups using Cox regression. Cancer was diagnosed among 7.3% of 4,085 metformin users compared with 11.6% of 4,085 comparators, with median times to cancer of 3.5 and 2.6 years, respectively (P < 0.001). The unadjusted hazard ratio (95% CI) for cancer was 0.46 (0.40–0.53). After adjusting for sex, age, BMI, A1C, deprivation, smoking, and other drug use, there was still a significantly reduced risk of cancer associated with metformin: 0.63 (0.53–0.75). These results suggest that metformin use may be associated with a reduced risk of cancer. A randomized trial is needed to assess whether metformin is protective in a population at high risk for cancer.
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影响因子：
5.6
作者：
Garmendia, Maria Luisa;Pereira, Ana;Atalah, Eduardo
通讯作者：
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