Mortality after incident cancer in people with and without type 2 diabetes: impact of metformin on survival.
Mortality after incident cancer in people with and without type 2 diabetes: impact of metformin on survival.
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DOI：
10.2337/dc11-1313
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发表时间：
2012-02
期刊：
影响因子：
16.2
通讯作者：
Morgan CL
中科院分区：
文献类型：
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作者：
Currie CJ;Poole CD;Jenkins-Jones S;Gale EA;Johnson JA;Morgan CL
2 型糖尿病与多种癌症的风险增加以及癌症诊断后生存率降低有关。我们检验了以下假设：与非糖尿病患者相比，糖尿病患者诊断出实体瘤癌症后的生存率降低，并且二甲双胍治疗会影响癌症诊断后的生存率。数据来自超过 350 个英国初级保健机构的回顾性队列研究。所有在 1990 年 1 月后出现第一个肿瘤的患有或未患有糖尿病的个体均被识别出来，并跟踪记录至 2009 年 12 月。糖尿病按治疗方案进一步分层。 Cox 比例风险模型用于比较所有癌症和特定癌症的全因死亡率。在 112,408 名符合资格的个人中，8,392 人 (7.5%) 患有 2 型糖尿病。与没有糖尿病的人相比，患有糖尿病的人的癌症死亡率增加（风险比 1.09 [95% CI 1.06–1.13]）。乳腺癌（1.32 [1.17–1.49]）和前列腺癌（1.19 [1.08–1.31]）死亡率增加，但肺癌死亡率下降（0.84 [0.77–0.92]）。通过糖尿病治疗进行分析时，磺脲类（1.13 [1.05–1.21]）或胰岛素（1.13 [1.01–1.27]）单药治疗的死亡率相对于非糖尿病患者有所增加，但二甲双胍单药治疗的死亡率降低（0.85 [0.78–0.93]）。这项研究证实，2 型糖尿病与癌症发生后较差的预后相关，但这种关联因糖尿病治疗和癌症部位而异。与其他糖尿病治疗方法相比以及与非糖尿病人群相比，二甲双胍与生存获益相关。
Type 2 diabetes is associated with an increased risk of several types of cancer and with reduced survival after cancer diagnosis. We examined the hypotheses that survival after a diagnosis of solid-tumor cancer is reduced in those with diabetes when compared with those without diabetes, and that treatment with metformin influences survival after cancer diagnosis. Data were obtained from >350 U.K. primary care practices in a retrospective cohort study. All individuals with or without diabetes who developed a first tumor after January 1990 were identified and records were followed to December 2009. Diabetes was further stratified by treatment regimen. Cox proportional hazards models were used to compare all-cause mortality from all cancers and from specific cancers. Of 112,408 eligible individuals, 8,392 (7.5%) had type 2 diabetes. Cancer mortality was increased in those with diabetes, compared with those without (hazard ratio 1.09 [95% CI 1.06–1.13]). Mortality was increased in those with breast (1.32 [1.17–1.49]) and prostate cancer (1.19 [1.08–1.31]) but decreased in lung cancer (0.84 [0.77–0.92]). When analyzed by diabetes therapy, mortality was increased relative to nondiabetes in those on monotherapy with sulfonylureas (1.13 [1.05–1.21]) or insulin (1.13 [1.01–1.27]) but reduced in those on metformin monotherapy (0.85 [0.78–0.93]). This study confirmed that type 2 diabetes was associated with poorer prognosis after incident cancer, but that the association varied according to diabetes therapy and cancer site. Metformin was associated with survival benefit both in comparison with other treatments for diabetes and in comparison with a nondiabetic population.
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影响因子：
--
作者：
Lipscombe, LL;Hux, JE;Booth, GL
通讯作者：
Booth, GL
影响因子：
16.2
作者：
Giovannucci E;Harlan DM;Archer MC;Bergenstal RM;Gapstur SM;Habel LA;Pollak M;Regensteiner JG;Yee D
通讯作者：
Yee D
影响因子：
6.9
作者：
Maruthur, Nisa M.;Bolen, Shari D.;Brancati, Frederick L.;Clark, Jeanne M.
通讯作者：
Clark, Jeanne M.
DOI：
10.1016/0021-9681(87)90171-8
发表时间：
1987-01-01
期刊：
JOURNAL OF CHRONIC DISEASES
影响因子：
--
作者：
CHARLSON, ME;POMPEI, P;MACKENZIE, CR
通讯作者：
MACKENZIE, CR
影响因子：
16.2
作者：
Libby G;Donnelly LA;Donnan PT;Alessi DR;Morris AD;Evans JM
通讯作者：
Evans JM