Division of Clinical Pharmacology and Toxicology, University Hospital Basel, Basel, Switzerland.
Diabetes Care. 2010 Jun;33(6):1304-8. doi: 10.2337/dc09-1791. Epub 2010 Mar 18.
To evaluate whether use of oral hypoglycemic agents is associated with an altered breast cancer risk in women.
Using the U.K.-based General Practice Research Database, we conducted a nested case-control analysis among 22,621 female users of oral antidiabetes drugs with type 2 diabetes. We evaluated whether they had an altered risk of breast cancer in relation to use of various types of oral hypoglycemic agents. Case and control patients with a recorded diagnosis of type 2 diabetes were matched on age, calendar time, and general practice, and the multivariate conditional logistic regression analyses were further adjusted for use of oral antidiabetes drugs, insulin, estrogens, smoking BMI, diabetes duration, and HbA1c (A1C).
We identified 305 case patients with a recorded incident diagnosis of breast cancer. The mean +/- SD age was 67.5 +/- 10.5 years at the time of the cancer diagnosis. Long-term use of >or=40 prescriptions (>5 years) of metformin, based on 17 exposed case patients and 120 exposed control patients, was associated with an adjusted odds ratio of 0.44 (95% CI 0.24-0.82) for developing breast cancer compared with no use of metformin. Neither short-term metformin use nor use of sulfonylureas or other antidiabetes drugs was associated with a materially altered risk for breast cancer.
A decreased risk of breast cancer was observed in female patients with type 2 diabetes using metformin on a long-term basis.
评估口服降糖药的使用是否与女性乳腺癌风险改变相关。
利用英国基于普通实践的研究数据库,我们在 22621 名患有 2 型糖尿病的女性口服抗糖尿病药物使用者中进行了一项嵌套病例对照分析。我们评估了她们使用各种类型的口服降糖药与乳腺癌风险改变之间的关系。病例和对照患者根据年龄、日历时间和普通实践进行了记录诊断为 2 型糖尿病的匹配,多变量条件逻辑回归分析进一步调整了口服抗糖尿病药物、胰岛素、雌激素、吸烟 BMI、糖尿病持续时间和糖化血红蛋白(A1C)的使用情况。
我们确定了 305 名记录有乳腺癌新发诊断的病例患者。癌症诊断时的平均年龄为 67.5 +/- 10.5 岁。根据 17 名暴露病例患者和 120 名暴露对照患者,长期使用>或=40 份处方(>5 年)的二甲双胍与不使用二甲双胍相比,发生乳腺癌的调整后比值比为 0.44(95%可信区间 0.24-0.82)。短期使用二甲双胍或使用磺酰脲类药物或其他抗糖尿病药物与乳腺癌风险的实质性改变无关。
在长期使用二甲双胍的 2 型糖尿病女性患者中,观察到乳腺癌风险降低。