Becker Claudia, Jick Susan S, Meier Christoph R, Bodmer Michael
Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, St. Johanns-Vorstadt 27, 4031, Basel, Switzerland.
Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, Lexington, MA, USA.
BMC Cancer. 2015 Oct 16;15:719. doi: 10.1186/s12885-015-1719-6.
Use of metformin has been associated with a decreased cancer risk. We aimed to explore whether use of metformin or other antidiabetic drugs is associated with a decreased risk for thyroid cancer.
We conducted a case-control analysis (1995 to 2014) using the U.K.-based Clinical Practice Research Datalink (CPRD). Cases had a first-time diagnosis of thyroid cancer, six controls per case were matched on age, sex, calendar time, general practice, and number of years of active history in the database prior to the index date. We assessed odds ratios (ORs) with 95 % confidence intervals (95 % CI), adjusted for body mass index (BMI), smoking, and diabetes mellitus.
In 1229 cases and 7374 matched controls, the risk of thyroid cancer associated with ever use of metformin yielded an adjusted OR of 1.48, 95 % CI 0.86-2.54. The relative risk estimate was highest in long-term (≥30 prescriptions) users of metformin (adjusted OR 1.83, 95 % CI 0.92-3.65), based on a limited number of 26 exposed cases. No such association was found in users of sulfonylurea, insulin, or thiazolidinediones (TZD). Neither a diabetes diagnosis (adjusted OR 1.17, 95 % CI 0.89-1.54), nor diabetes duration >8 years (adjusted OR 1.22, 95 % CI 0.60-2.51) altered the risk of thyroid cancer.
In our observational study with limited statistical power, neither use of metformin nor of other antidiabetic drugs were associated with a decreased risk of thyroid cancer.
二甲双胍的使用与癌症风险降低有关。我们旨在探讨二甲双胍或其他抗糖尿病药物的使用是否与甲状腺癌风险降低有关。
我们使用英国临床实践研究数据链(CPRD)进行了一项病例对照分析(1995年至2014年)。病例为首次诊断为甲状腺癌的患者,每例病例匹配6名对照,对照在年龄、性别、日历时间、全科医疗以及索引日期之前在数据库中的活跃病史年限方面与病例匹配。我们评估了比值比(OR)及其95%置信区间(95%CI),并对体重指数(BMI)、吸烟和糖尿病进行了调整。
在1229例病例和7374例匹配对照中,曾使用二甲双胍与甲状腺癌风险相关的调整后OR为1.48,95%CI为0.86 - 2.54。基于仅26例暴露病例的有限数量,二甲双胍长期(≥30次处方)使用者的相对风险估计最高(调整后OR为1.83,95%CI为0.92 - 3.65)。在使用磺脲类、胰岛素或噻唑烷二酮类(TZD)药物的患者中未发现此类关联。糖尿病诊断(调整后OR为1.17,95%CI为0.89 - 1.54)以及糖尿病病程>8年(调整后OR为1.22,95%CI为0.60 - 2.51)均未改变甲状腺癌风险。
在我们这项统计效力有限的观察性研究中,二甲双胍或其他抗糖尿病药物的使用均与甲状腺癌风险降低无关。