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甘精胰岛素与癌症风险:一项荟萃分析。

Insulin glargine and risk of cancer: a meta-analysis.

机构信息

Department of Geratology, First Affiliated Hospital, Nanjing Medical University, Nanjing, China.

出版信息

Int J Biol Markers. 2012 Oct 8;27(3):e241-6. doi: 10.5301/JBM.2012.9349.

Abstract

AIMS

Recently, more and more attention has been drawn on the long-term effects of insulin glargine. Here we strived to estimate the association of cancer occurrence with the use of insulin glargine.

METHODS

We searched all the publications regarding the association between cancer occurrence and the use of insulin glargine using the US National Library of Medicine's PubMed database. Data were independently extracted and analyzed using random or fixed effects meta-analysis depending upon the degree of heterogeneity.

RESULTS

Seven cohort studies were included in the meta-analysis. Cancer occurrence had no significant difference in glargine-treated patients compared to patients treated with other insulins (RR=0.86, 95% CI=0.69-1.07, p=0.17, P(heterogeneity)<0.00001). In our subgroup analysis, glargine, compared to other insulins, did not increase the risk of breast cancer (RR=1.14, 95% CI=0.65-2.02, p=0.65, P(heterogeneity)=0.002), prostate cancer (RR=1.00, 95% CI=0.79-1.26, p=0.99, P(heterogeneity)=0.78), pancreatic cancer (RR=0.57, 95% CI=0.14-2.35, p=0.44, P(heterogeneity)=0.0002) and gastrointestinal cancer (RR=0.80, 95% CI=0.62-1.02, p=0.07, P(heterogeneity)=0.86).

CONCLUSIONS

This meta-analysis of open-label studies does not support an increased cancer risk in patients treated with insulin glargine. The result provides confidence for the development of insulin glargine, but needs confirmation by further clinical studies.

摘要

目的

最近,人们越来越关注甘精胰岛素的长期影响。在这里,我们旨在评估癌症发生与甘精胰岛素使用之间的关联。

方法

我们使用美国国立医学图书馆的 PubMed 数据库搜索了所有关于癌症发生与甘精胰岛素使用之间关联的出版物。根据异质性程度,使用随机或固定效应荟萃分析独立提取和分析数据。

结果

共有 7 项队列研究纳入荟萃分析。与接受其他胰岛素治疗的患者相比,甘精胰岛素治疗的患者癌症发生率无显著差异(RR=0.86,95%CI=0.69-1.07,p=0.17,P(异质性)<0.00001)。在我们的亚组分析中,与其他胰岛素相比,甘精胰岛素并未增加乳腺癌(RR=1.14,95%CI=0.65-2.02,p=0.65,P(异质性)=0.002)、前列腺癌(RR=1.00,95%CI=0.79-1.26,p=0.99,P(异质性)=0.78)、胰腺癌(RR=0.57,95%CI=0.14-2.35,p=0.44,P(异质性)=0.0002)和胃肠道癌(RR=0.80,95%CI=0.62-1.02,p=0.07,P(异质性)=0.86)的风险。

结论

这项开放标签研究的荟萃分析不支持接受甘精胰岛素治疗的患者癌症风险增加。该结果为甘精胰岛素的开发提供了信心,但需要进一步的临床研究加以证实。

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