Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
Diabetes Metab J. 2013 Apr;37(2):125-31. doi: 10.4093/dmj.2013.37.2.125. Epub 2013 Apr 16.
Recently, several studies reported that the cancer incidence in type 2 diabetes patients is higher than in the general population. Although a number of risks are shared between cancer and diabetes patients, there have been few studies of its correlation. We evaluated the influences of several factors including low density lipoprotein cholesterol (LDL-C), albuminuria and use of metformin on the risk of cancer in patients with type 2 diabetes.
We enrolled 1,320 patients with at least 5 years of follow-up and 73 patients were diagnosed with cancer during this period. The associations of the risk factors with cancer incidence were evaluated by multiple regression analysis. The subjects were placed into two subgroups based on metformin dosage (<1,000 mg/day, ≥1,000 mg/day) and we compared cancer incidence using analysis of covariance.
LDL-C and albuminuria were not significantly correlated with cancer risk. In contrast, metformin showed a reverse correlation with cancer risk (P=0.006; relative risk, 0.574). In the metformin nonadministration group, smoking, male gender, and high triglyceride levels tended to be contributing factors without statistical significance. Cancer occurence was lower in the low dose metformin group (less than 1,000 mg/day) (P=0.00).
These results suggest that the administration of low dose metformin in patients with type 2 diabetes may be associated with a reduced risk of cancer.
最近，有几项研究报告称，2 型糖尿病患者的癌症发病率高于普通人群。尽管癌症和糖尿病患者有一些共同的风险因素，但对其相关性的研究较少。我们评估了包括低密度脂蛋白胆固醇（LDL-C）、白蛋白尿和二甲双胍使用在内的几种因素对 2 型糖尿病患者癌症风险的影响。
我们纳入了 1320 名至少随访 5 年的患者，在此期间有 73 名患者被诊断为癌症。通过多回归分析评估了这些危险因素与癌症发病率的相关性。根据二甲双胍剂量（<1000mg/天，≥1000mg/天）将患者分为两组，并通过协方差分析比较癌症发病率。
LDL-C 和白蛋白尿与癌症风险无显著相关性。相反，二甲双胍与癌症风险呈负相关（P=0.006；相对风险，0.574）。在未使用二甲双胍的组中，吸烟、男性和高甘油三酯水平倾向于成为促成因素，但无统计学意义。低剂量二甲双胍组（<1000mg/天）癌症发生率较低（P=0.00）。
这些结果表明，2 型糖尿病患者低剂量使用二甲双胍可能与癌症风险降低有关。
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