Wang Zheng, Lai Song-Tao, Xie Li, Zhao Jian-Dong, Ma Ning-Yi, Zhu Ji, Ren Zhi-Gang, Jiang Guo-Liang
Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
Department of Statistics, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
Diabetes Res Clin Pract. 2014 Oct;106(1):19-26. doi: 10.1016/j.diabres.2014.04.007. Epub 2014 Apr 18.
Recent epidemiological studies indicated that use of metformin might decrease the risk of various cancers among patients with type 2 diabetes mellitus (T2DM). However, its influence on pancreatic cancer was controversial. Therefore, we did a meta-analysis of currently available observational studies on the issue.
We did a PubMed and ISI Web of Science search for observational articles. The pooled relative risk (RR) was estimated using a random-effect model. Heterogeneity was evaluated using I(2) statistic. Subgroup analysis was performed to explore the source of heterogeneity and confirm the overall estimates. Publication bias was also examined.
The analysis included 11 articles (13 studies) comprising 10 cohort studies and 3 case-control studies. Use of metformin was associated with a significant lower risk of pancreatic cancer [RR 0.63, 95% confidence internal (CI) 0.46-0.86, p=0.003]. In a total 11 subgroup analyses, 5 provided the consistent result with pooled effect estimates of overall analysis. No publication bias was detected by Begg's (Z=-0.79, p=0.428) and Egger's test (t=-0.92, p=0.378).
From present observational studies, use of metformin appears to be associated with a reduced risk of pancreatic cancer in patients with T2DM. Further investigation is needed.
近期的流行病学研究表明,二甲双胍的使用可能会降低2型糖尿病(T2DM)患者患各种癌症的风险。然而,其对胰腺癌的影响存在争议。因此,我们针对该问题对目前可用的观察性研究进行了一项荟萃分析。
我们在PubMed和ISI Web of Science上搜索观察性文章。使用随机效应模型估计合并相对风险(RR)。使用I²统计量评估异质性。进行亚组分析以探索异质性来源并确认总体估计值。还检查了发表偏倚。
该分析纳入了11篇文章(13项研究),包括10项队列研究和3项病例对照研究。二甲双胍的使用与胰腺癌风险显著降低相关[RR 0.63,95%置信区间(CI)0.46 - 0.86,p = 0.003]。在总共11项亚组分析中,5项与总体分析的合并效应估计结果一致。Begg检验(Z = -0.79,p = 0.428)和Egger检验(t = -0.92,p = 0.378)均未检测到发表偏倚。
从目前的观察性研究来看,二甲双胍的使用似乎与T2DM患者患胰腺癌风险降低有关。需要进一步研究。