Yang's ENT Clinic, Taichung, Taiwan.
Department of Public Health, China Medical University, Taichung, Taiwan; Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
Diabetes Res Clin Pract. 2015 Dec;110(3):285-90. doi: 10.1016/j.diabres.2015.10.005. Epub 2015 Oct 22.
We aimed to examine whether morphine treatment is associated with type 2 diabetes mellitus (T2DM) in female breast cancer patients.
We conducted a retrospective cohort analysis of the Longitudinal Health Insurance Database for Catastrophic Illness Patients in Taiwan. A total of 31,112 women with breast cancer without T2DM history during the period 2000-2005 were identified, divided into morphine and non-morphine users (8071 and 23,041 patients, respectively), and the hazard ratios of newly diagnosed T2DM during the period 2005-2010 were calculated. We used a Cox proportional hazard model with time-dependent exposure covariates to estimate the risk of T2DM. The dosage of morphine was counted as defined daily dose and its effect was assessed by multivariable Cox proportional hazard regression controlling age, Charlson comorbidity index, outpatient department visits, antipsychotics, and breast cancer drugs.
Morphine users were 1.24 times more likely to suffer from T2DM than non-morphine users (95% CI=1.04-1.49). Risk increased slightly with the morphine dosage, in patients aged 35-49 years, and with tamoxifen, aromatase inhibitors, and antipsychotics treatment.
The incidence of T2DM is associated with morphine treatment in female breast cancer patients. A higher risk was observed in patients aged 35-49 years using higher dose of morphine, and may be increased by tamoxifen and aromatase inhibitors.
本研究旨在探讨女性乳腺癌患者接受吗啡治疗是否与 2 型糖尿病（T2DM）相关。
我们对台湾灾难性疾病医疗保险数据库中的 31112 例 2000-2005 年期间无 T2DM 病史的女性乳腺癌患者进行了回顾性队列分析。将其分为吗啡组和非吗啡组（分别为 8071 例和 23041 例），并计算 2005-2010 年期间新诊断 T2DM 的风险比。我们采用时依性暴露协变量的 Cox 比例风险模型来估计 T2DM 的风险。吗啡剂量以规定日剂量计算，并通过多变量 Cox 比例风险回归来评估其作用，该回归模型控制了年龄、Charlson 合并症指数、门诊就诊次数、抗精神病药和乳腺癌药物。
与非吗啡组相比，吗啡组发生 T2DM 的风险高 1.24 倍（95%CI=1.04-1.49）。在年龄为 35-49 岁的患者、使用较高剂量吗啡、且接受他莫昔芬、芳香化酶抑制剂和抗精神病药治疗的患者中，风险略有增加。
女性乳腺癌患者 T2DM 的发生与吗啡治疗相关。年龄在 35-49 岁、使用较高剂量吗啡的患者风险更高，且可能会因他莫昔芬和芳香化酶抑制剂而增加。
