Sulphonylureas and cancer: a case-control study
Sulphonylureas and cancer: a case-control study
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DOI：
10.1007/s00592-008-0083-2
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发表时间：
2009-12-01
影响因子：
3.8
通讯作者：
Mannucci, Edoardo
中科院分区：
文献类型：
--
作者：
Monami, Matteo;Lamanna, Caterina;Mannucci, Edoardo
本研究旨在评估不同磺脲类药物治疗2型糖尿病患者的恶性肿瘤发生率。进行了一项匹配的病例对照研究。195例糖尿病患者，年龄69.0 +/- A 9.2岁，伴有恶性肿瘤。对照组是195名未患癌症的糖尿病患者，他们在年龄、性别、糖尿病病程、BMI、HbA1(c)、合并症、吸烟和酗酒方面与相应的病例相匹配。评估事件发生前10年（或匹配指标日期）的降糖药暴露情况。在对伴随治疗进行调整后，二甲双胍和格列齐特暴露超过36个月与癌症风险的显著降低相关(比值比95% CI分别为0.28 （0.13-0.57),p < 0.001和0.40 (0.21-0.57),p = 0.004）。相反，使用格列本脲至少36个月与恶性肿瘤发生率增加相关(比值比2.62 (1.26-5.42)；P = 0.009)。用胰岛素、噻唑烷二酮或阿卡波糖治疗与癌症发病率的显著差异无关。长期使用单独的磺脲类药物治疗可能对癌症风险有不同的影响。特别是，格列齐特可能的保护作用，以及与格列本脲相关的风险，值得进一步研究。
This study was aimed at the assessment of incidence of malignancies in type 2 diabetic patients treated with different sulphonylureas. A matched case-control study was performed. Cases were 195 diabetic patients aged 69.0 +/- A 9.2 years who had an incident malignancy. Controls were 195 diabetic patients, unaffected by cancer, who were matched with the corresponding case for age, sex, duration of diabetes, BMI, HbA1(c), comorbidity, smoking and alcohol abuse. Exposure to hypoglycaemic drugs during the 10 years preceding the event (or matching index date) was assessed. After adjusting for concomitant therapies, exposure to metformin and gliclazide for more than 36 months was associated with a significant reduction in the risk of cancer (adj. ORs with 95% CI: 0.28 (0.13-0.57), p < 0.001, and 0.40 (0.21-0.57), p = 0.004, respectively). Conversely, use of glibenclamide for at least 36 months was associated with increased incidence of malignancies (adj. OR 2.62 (1.26-5.42); p = 0.009). Treatment with insulin, thiazolidinediones, or acarbose, was not associated with significant differences in the incidence of cancer. Long-term treatments with individual sulphonylureas could have differential effects on the risk of cancer. In particular, the possible protective effect of gliclazide, as well as the risk associated with glibenclamide, deserves further investigation.