Hsieh Ming-Chia, Lee Tzu-Chi, Cheng Shu-Min, Tu Shih-Te, Yen Ming-Hong, Tseng Chin-Hsiao
Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.
Exp Diabetes Res. 2012;2012:413782. doi: 10.1155/2012/413782. Epub 2012 Jun 5.
To investigate the association between type 2 diabetes, glucose-lowering therapies (monotherapy with either metformin, sulphonylurea or insulin) and cancer risk in Taiwan.
Using Taiwan's National Health Research Institutes database of 1,000,000 random subjects from 2000-2008, we found 61777 patients with type 2 diabetes (age ≥20 years) and 677378 enrollees with no record of diabetes.
After adjusting for age and sex, we found patients with diabetes to have significantly higher risk of all cancers (OR: 1.176; 95% CI: 1.149-1.204, P < 0.001). Diabetic patients treated with insulin or sulfonylureas had significantly higher risk of all cancers, compared to those treated with metformin (OR: 1.583; 95% CI: 1.389-1.805, P < 0.001 and OR: 1.784; 95% CI: 1.406-2.262, P < 0.001). Metformin treatment was associated with a decreased risk of colon and liver cancer compared to sulphonylureas or insulin treatment. Sulfonylureas treatment was associated with an increased risk of breast and lung cancer compared to metformin therapy.
Taiwanese with type 2 diabetes are at a high risk of breast, prostate, colon, lung, liver and pancreatic cancer. Those treated with insulin or sulfonylureas monotherapy are more likely to develop colon and liver cancer than those treated with metformin.
探讨台湾地区2型糖尿病、降糖治疗（二甲双胍、磺脲类药物或胰岛素单药治疗）与癌症风险之间的关联。
利用台湾国立卫生研究院2000 - 2008年100万随机受试者数据库，我们找出了61777例2型糖尿病患者（年龄≥20岁）以及677378例无糖尿病记录的登记参与者。
在对年龄和性别进行校正后，我们发现糖尿病患者患所有癌症的风险显著更高（比值比：1.176；95%置信区间：1.149 - 1.204，P < 0.001）。与接受二甲双胍治疗的患者相比，接受胰岛素或磺脲类药物治疗的糖尿病患者患所有癌症的风险显著更高（比值比：1.583；95%置信区间：1.389 - 1.805，P < 0.001；比值比：1.784；95%置信区间：1.406 - 2.262，P < 0.001）。与磺脲类药物或胰岛素治疗相比，二甲双胍治疗与结肠癌和肝癌风险降低相关。与二甲双胍治疗相比，磺脲类药物治疗与乳腺癌和肺癌风险增加相关。
台湾地区的2型糖尿病患者患乳腺癌、前列腺癌、结肠癌、肺癌、肝癌和胰腺癌的风险较高。与接受二甲双胍治疗的患者相比，接受胰岛素或磺脲类药物单药治疗的患者更易患结肠癌和肝癌。
