Chen Mei-Jyh, Tsan Yu-Tse, Liou Jyh-Ming, Lee Yi-Chia, Wu Ming-Shiang, Chiu Han-Mo, Wang Hsiu-Po, Chen Pau-Chung
Institute of Occupational Medicine and Industry Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan.
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Int J Cancer. 2016 Feb 1;138(3):594-603. doi: 10.1002/ijc.29813. Epub 2015 Aug 31.
The aim of this study was to determine whether statin use exerts a protective effect against pancreatic cancer in Type 2 diabetic patients. A retrospective population-based cohort study was designed to analyze the National Health Insurance Research database (NHIRD) from 1997-2010 in Taiwan. A total of 1,140,617 patients with a first-time diagnosis of Type 2 diabetes were enrolled. The event was defined as newly diagnosed pancreatic cancer. A Cox proportional hazards regression model with time-dependent covariates was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for risk of pancreatic cancer associated with statin use in the diabetic cohort. A total of 2,341 patients with newly diagnosed pancreatic cancer were identified in the diabetic cohort during the follow-up period of 6,968,217.1 person-years. In this cohort, 450,282 patients were defined as statin users (statin use ≥ 28 cumulative defined daily dose [cDDD] in 1 year) and 0.14% had pancreatic cancer; 690,335 patients were statin nonusers (statin use <28 cDDD in 1 year) and 0.25% had pancreatic cancer. Statin use significantly decreased the risk of pancreatic cancer (adjusted HRs: 0.78 in 28-83 cDDD per year; 0.48 in 84-180 cDDD per year; and 0.33 in >180 cDDD per year) after adjusting for multiple confounders. There was a significant dose-effect of statin use for the risk of pancreatic cancer (p for trend: <0.001). Statin use may be associated with a reduced risk of pancreatic cancer in Type 2 diabetic patients. More research is needed to clarify this association.
本研究的目的是确定使用他汀类药物是否对2型糖尿病患者的胰腺癌具有保护作用。一项基于人群的回顾性队列研究旨在分析台湾1997年至2010年的国民健康保险研究数据库（NHIRD）。共纳入1140617例首次诊断为2型糖尿病的患者。事件定义为新诊断的胰腺癌。使用具有时间依赖性协变量的Cox比例风险回归模型计算糖尿病队列中与使用他汀类药物相关的胰腺癌风险的风险比（HRs）和95%置信区间（CIs）。在6968217.1人年的随访期内，糖尿病队列中共有2341例新诊断为胰腺癌的患者。在该队列中，450282例患者被定义为他汀类药物使用者（1年内他汀类药物使用≥28累积限定日剂量[cDDD]），0.14%患有胰腺癌；690335例患者为非他汀类药物使用者（1年内他汀类药物使用<28 cDDD），0.25%患有胰腺癌。在调整多个混杂因素后，使用他汀类药物显著降低了胰腺癌风险（调整后的HRs：每年28 - 83 cDDD为0.78；每年84 - 180 cDDD为0.48；每年>180 cDDD为0.33）。他汀类药物使用对胰腺癌风险存在显著的剂量效应（趋势p值：<0.001）。使用他汀类药物可能与降低2型糖尿病患者的胰腺癌风险相关。需要更多研究来阐明这种关联。
