Metformin use among type 2 diabetics and risk of pancreatic cancer in a clinic-based case-control study.
Metformin use among type 2 diabetics and risk of pancreatic cancer in a clinic-based case-control study.
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一项基于临床的病例对照研究中二甲双胍在 2 型糖尿病患者中的使用与胰腺癌的风险。
DOI：
10.1002/ijc.29120
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发表时间：
2015
影响因子：
6.4
通讯作者：
Bracci,PaigeM
中科院分区：
文献类型：
--
作者：
Walker,EvanJ;Ko,AndrewH;Holly,ElizabethA;Bracci,PaigeM
更好地了解糖尿病和胰腺癌（PC）之间的关系可以为预防和/或早期检测策略提供信息。在一些观察性临床研究中，二甲双胍与某些癌症（包括PC）的风险降低相关。我们评估了二甲双胍的使用是否与2型糖尿病（DM 2）患者的PC风险相关，以及二甲双胍的使用是否调节了DM 2与PC风险之间的关联。从2006年至2011年，共招募了536例PC病例和869例频率匹配的对照，主要来自加州大学旧金山弗朗西斯科医疗诊所。符合条件的参与者完成了直接访谈，使用结构化的风险因素问卷。在仅限于糖尿病患者的分析中，使用倾向评分加权非条件logistic回归方法评估二甲双胍使用与PC风险之间的相关性，并在总研究人群中调整多变量logistic模型。在仅限于DM 2（N= 170）受试者的分析中，既往使用二甲双胍与PC风险无关（校正OR：1.01，95% CI：0.61-1.68）。以非糖尿病患者为参照组的总研究人群（N= 1,405）中，PC风险与糖尿病病程呈负相关（p趋势< 0.001）。此外，当DM 2参与者按曾经/从未使用二甲双胍分组并与非糖尿病患者相比时，二甲双胍使用并不影响DM 2与PC风险之间的关联（从未使用者：OR：1.44，95% CI：0.78-2.67;曾经使用者：OR：1.19，95% CI：0.72-1.99）。我们基于临床的病例对照研究的结果表明，二甲双胍的使用与DM 2患者的PC风险无关，并且不会改变DM 2与PC风险之间的相关性。
A better understanding of the association between diabetes and pancreatic cancer (PC) may inform prevention and/or early detection strategies. Metformin has been associated with reduced risk of certain cancers, including PC, in some observational clinical studies. We assessed whether metformin use was associated with PC risk among those with type 2 diabetes (DM2), and whether metformin use modulated the association between DM2 and risk of PC. In total, 536 PC cases and 869 frequency‐matched controls were recruited predominantly from University of California San Francisco medical clinics from 2006 to 2011. Eligible participants completed direct interviews using a structured risk factor questionnaire. The association between metformin use and PC risk was assessed using propensity score‐weighted unconditional logistic regression methods in analyses restricted to diabetics and adjusted multivariable logistic models in the total study population. Ever use of metformin was not associated with PC risk in analyses restricted to DM2 (N= 170) participants (adjusted OR: 1.01, 95% CI: 0.61–1.68). In the total study population (N= 1,405) using nondiabetics as the referent group, PC risk was inversely associated with diabetes duration (ptrend< 0.001). Further, when DM2 participants were grouped by ever/never use of metformin and compared with nondiabetics, metformin use did not affect the association between DM2 and PC risk (never users: OR: 1.44, 95% CI: 0.78–2.67; ever users: OR: 1.19, 95% CI: 0.72–1.99). Results from our clinic‐based case–control study suggest that metformin use is not associated with PC risk among those with DM2 and does not alter the association between DM2 and PC risk.