Doses of insulin and its analogues and cancer occurrence in insulin-treated type 2 diabetic patients.
Doses of insulin and its analogues and cancer occurrence in insulin-treated type 2 diabetic patients.
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DOI：
10.2337/dc10-0476
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发表时间：
2010-09
期刊：
影响因子：
16.2
通讯作者：
Rotella CM
中科院分区：
文献类型：
--
作者：
Mannucci E;Monami M;Balzi D;Cresci B;Pala L;Melani C;Lamanna C;Bracali I;Bigiarini M;Barchielli A;Marchionni N;Rotella CM
最近的流行病学研究表明，一些胰岛素类似物可能与癌症风险增加有关。本研究旨在评估不同胰岛素类似物与癌症发病率的长期相关性。通过从风险集中抽取对照受试者，从队列研究数据集（n = 1，340例接受胰岛素治疗的糖尿病门诊患者）生成嵌套病例对照研究数据集。对于每个病例受试者，对照受试者（最多5名）从队列中随机选择，这些成员在病例受试者相同的随访时间内有风险。5岁年龄组、性别和BMI类别（<18.5、18.5-24.9、25-29.9和≥30 kg/m2）被视为额外的分类匹配变量。在75.9个月（四分位距27.4-133.7）的中位随访期间，将112例癌症病例与370例匹配的对照组进行了比较。观察到病例受试者的甘精胰岛素平均日剂量显著高于对照受试者（0.24 IU/kg/天[0.10-0.39] vs 0.16 IU/kg/天[0.12-0.24]，P = 0.036）。即使在调整了Charlson合并症评分、其他类型的胰岛素给药和二甲双胍暴露后，发生癌症与甘精胰岛素剂量≥0.3 IU/kg/d相关（比值比5.43 [95% CI 2.18-13.53]，P < 0.001）。对于人胰岛素或其他类似物，未发现癌症发病率与胰岛素剂量之间的相关性。癌症与较高甘精胰岛素剂量之间可能存在相关性表明，在评估胰岛素及其类似物与癌症的可能相关性时，应始终考虑剂量。
Recent epidemiological studies suggested that some insulin analogues could be associated with increased risk of cancer. The present study is aimed at assessing the long-term association of different insulin analogues with cancer incidence. A nested case-control study dataset was generated from the cohort study dataset (n = 1,340 insulin-treated diabetic outpatients) by sampling control subjects from the risk sets. For each case subject, the control subjects (up to five) were chosen randomly from those members of the cohort who are at risk for the same follow-up time of the case subject. Five-year age classes, sex, and BMI classes (<18.5, 18.5–24.9, 25–29.9, and ≥30 kg/m2) were considered as additional categorical matching variables. During a median follow-up of 75.9 months (interquartile range 27.4–133.7), 112 case subjects of incident cancer were compared with 370 matched control subjects. A significantly higher mean daily dose of glargine was observed in case subjects than in control subjects (0.24 IU/kg/day [0.10–0.39] versus 0.16 IU/kg/day [0.12–0.24], P = 0.036). Incident cancer was associated with a dose of glargine ≥0.3 IU/kg/day even after adjusting for Charlson comorbidity score, other types of insulin administration, and metformin exposure (odds ratio 5.43 [95% CI 2.18–13.53], P < 0.001). No association between incident cancer and insulin doses was found for human insulin or other analogues. The possibility of association between cancer and higher glargine doses suggests that dosages should always be considered when assessing the possible association of insulin and its analogues with cancer.
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影响因子：
3.8
作者：
Monami, Matteo;Lamanna, Caterina;Mannucci, Edoardo
通讯作者：
Mannucci, Edoardo
影响因子：
16.2
作者：
Erbel, Saskia;Reers, Christina;Ritzel, Robert A.
通讯作者：
Ritzel, Robert A.
影响因子：
3
作者：
Mayer, Doris;Chantelau, Ernst
通讯作者：
Chantelau, Ernst
影响因子：
8.2
作者：
Home, P. D.;Lagarenne, P.
通讯作者：
Lagarenne, P.
临床使用的胰岛素类似物的受体结合与代谢和有丝分裂效力的相关性
影响因子：
7.7
作者：
Kurtzhals, P;Schäffer, L;Trüb, T
通讯作者：
Trüb, T