Cancer risks in thiazolidinedione users compared to other anti-diabetic agents
Cancer risks in thiazolidinedione users compared to other anti-diabetic agents
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DOI：
10.1002/pds.1352
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发表时间：
2007-05-01
影响因子：
2.6
通讯作者：
Qizilbash, Nawab
中科院分区：
文献类型：
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作者：
Koro, Carol;Barrett, Steven;Qizilbash, Nawab
目的：我们进行了三项巢式病例对照研究，以评估暴露于噻唑烷二酮（TZDs）与其他抗糖尿病药物的患者发生乳腺癌、结肠癌和前列腺癌的风险。方法从美国综合医疗保健信息服务数据库中选取126 971例服用抗糖尿病药物的糖尿病患者，按年龄、性别、日历年和时间进行对照。513例乳腺癌患者与2557例对照组相匹配，408例结肠癌患者与2027例对照组相匹配，643例前列腺癌患者与3176例对照组相匹配。在指标日期前90天内暴露于抗糖尿病药物被定义为最近暴露，在随访期间的任何时间被定义为曾经暴露。结果与口服单药治疗、口服双药治疗、口服三联治疗、胰岛素单药治疗、胰岛素和口服治疗以及所有非tzd降糖药相比，曾经暴露于tzd的癌症的校正优势比和95%CI分别为：0.91（0.69-1.20）、0.80（0.56-1.14）、0.87（0.32-2.35）、1.27（0.61-2.67）、0.71（0.36-1.37）、0.89 (0.68-1.15)；结肠癌:1.06(0.80 - -1.40),1.12(0.77 - -1.63),1.73(0.39 - -7.78),4.46(1.05 - -19.00),1.06(0.50 - -2.26)1.03(0.80 - -1.32)和前列腺癌:1.08 (0.85 - -1.37),0.89 (0.66 - -1.21);0.82 (0.33 - -2.06);1.80(0.79 - -4.07), 1.10(0.55 - -2.18), 1.04(0.83 - -1.31)。癌症发生后90天内的暴露结果也类似。结论：我们的研究结果表明，TZD对所研究的癌症（结肠癌、前列腺癌和乳腺癌）发展可能性的影响似乎是中性的，并不支持TZD对所研究的癌症的有益或有害影响。版权所有(c) 2006约翰威利父子有限公司
Purpose We conducted three nested case-control studies to evaluate the risk of breast, colon, and prostate cancers developing in patients exposed to thiazolidinediones (TZDs) compared with other anti-diabetic agents.Methods Cancer cases were matched to five controls by age, gender, calendar year, and time in the database from a cohort of 126 971 diabetic patients taking anti-diabetic medication in the US Integrated Healthcare Information Services database. Five hundred thirteen breast cancer cases were matched with 2557 controls, 408 cases of colon cancer were matched with 2027 controls and 643 cases of prostate cancer were matched with 3176 controls. Exposure to an anti-diabetic agent within 90 days preceding the index date was defined as recent exposure and at any time during the follow-up was defined as ever exposed.Results The adjusted odds ratios and 95%CI of cancer from ever exposure to TZDs compared to oral monotherapy, oral dual therapy, oral triple therapy, insulin monotherapy, insulin and oral therapy and all non-TZD anti-diabetic agents were, respectively for breast cancer: 0.91 (0.69-1.20), 0.80 (0.56-1.14), 0.87 (0.32-2.35), 1.27 (0.61-2.67), 0.71 (0.36-1.37), 0.89 (0.68-1.15); for colon cancer: 1.06 (0.80-1.40), 1.12 (0.77-1.63), 1.73 (0.39-7.78), 4.46 (1.05-19.00), 1.06 (0.50-2.26) 1.03 (0.80-1.32) and for prostate cancer: 1.08 (0.85-1.37), 0.89 (0.66-1.21); 0.82 (0.33-2.06); 1.80 (0.79-4.07), 1.10 (0.55-2.18), 1.04 (0.83-1.31). Results for exposure within 90 days of the date of the cancer were similar.Conclusions Our findings suggest that the effect of TZDs on the likelihood of development of the cancers studied (colon, prostate and breast) appears to be neutral and do not support a beneficial or deleterious effect of TZD on the cancers studied. Copyright (c) 2006 John Wiley & Sons, Ltd.