Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland.
Am J Gastroenterol. 2012 Apr;107(4):620-6. doi: 10.1038/ajg.2011.483. Epub 2012 Jan 31.
The objective of this study was to explore the association between use of metformin or other antidiabetic drugs, diabetes, and the risk of pancreatic cancer.
We conducted a case-control study using the UK-based General Practice Research Database (GPRD). Cases had a first-time diagnosis of pancreatic cancer, and six controls per case were matched on age, sex, calendar time, general practice, and number of years of active history in the GPRD before the index date. Results were further adjusted in multivariate logistic regression analyses for potential confounders such as body mass index, smoking, alcohol consumption, and diabetes duration.
In all, 2,763 case patients with a recorded diagnosis of pancreatic cancer were identified. Mean age ± s.d. was 69.5 ± 11.0 years. Long-term use (≥ 30 prescriptions) of metformin was not associated with a materially altered risk of pancreatic cancer (adjusted odds ratio (adj. OR): 0.87, 95% confidence interval (CI): 0.59-1.29), but there was a suggestion of effect modification by gender, as long-term use of metformin was linked to a decreased risk in women (adj. OR: 0.43, 95% CI: 0.23-0.80). Both use of sulfonylureas (≥ 30 prescriptions, adj. OR: 1.90, 95% CI: 1.32-2.74) and of insulin (≥ 40 prescriptions, adj. OR: 2.29, 95% CI: 1.34-3.92) were associated with an increased risk of pancreatic cancer.
Use of metformin was associated with a decreased risk of pancreatic cancer in women only, whereas use of sulfonylureas and of insulin was associated with an increased risk of pancreatic cancer.
本研究旨在探讨二甲双胍或其他抗糖尿病药物的使用、糖尿病与胰腺癌风险之间的关联。
我们使用基于英国的全科医生研究数据库（GPRD）进行了一项病例对照研究。病例组首次被诊断为胰腺癌，每个病例匹配 6 名对照组，按年龄、性别、日历时间、全科医生和指数日期前 GPRD 中活跃病史的年数进行匹配。在多变量逻辑回归分析中，进一步调整了潜在混杂因素，如体重指数、吸烟、饮酒和糖尿病病程。
共确定了 2763 名记录有胰腺癌诊断的病例患者。平均年龄 ± s.d.为 69.5 ± 11.0 岁。长期（≥ 30 剂）使用二甲双胍与胰腺癌风险无明显变化相关（调整后的优势比（adj. OR）：0.87，95%置信区间（CI）：0.59-1.29），但存在性别效应修饰的迹象，因为长期使用二甲双胍与女性的风险降低相关（adj. OR：0.43，95% CI：0.23-0.80）。长期使用磺脲类药物（≥ 30 剂，adj. OR：1.90，95% CI：1.32-2.74）和胰岛素（≥ 40 剂，adj. OR：2.29，95% CI：1.34-3.92）均与胰腺癌风险增加相关。
仅在女性中，二甲双胍的使用与胰腺癌风险降低相关，而磺脲类药物和胰岛素的使用与胰腺癌风险增加相关。
