Tseng Chin-Hsiao
Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Oncotarget. 2017 Jan 10;8(2):3042-3048. doi: 10.18632/oncotarget.13824.
This study investigated whether rosiglitazone may affect breast cancer risk in female patients with type 2 diabetes mellitus in Taiwan. The reimbursement database of all female patients with type 2 diabetes mellitus under oral antidiabetic agents or insulin from 1996 to 2009 was retrieved from the National Health Insurance. An entry date was set on 1 January 2006 and a total of 431447 patients were followed up for breast cancer incidence till the end of 2009. Incidences for ever users, never users and subgroups of rosiglitazone dose-response parameters (tertile cutoffs of cumulative duration and cumulative dose) were calculated and hazard ratios estimated by Cox regression. There were 53029 ever users and 378418 never users, respective numbers of incident breast cancer 410 (0.77%) and 3292 (0.87%), and respective incidence 217.53 and 249.12 per 100000 person-years. The overall hazard ratio was 0.889 (95% confidence interval: 0.797-0.992) in the fully adjusted model. Significantly lower risk was observed for the third tertiles of cumulative duration (> 14 months) and cumulative dose (> 1792 mg) while compared to never users, with respective adjusted hazard ratio of 0.815 (95% confidence interval: 0.682-0.973) and 0.815 (95% confidence interval: 0.682-0.974). Additionally, a significant interaction between metformin and rosiglitazone was observed. The lowest risk was seen in patients who used both drugs (hazard ratio 0.812, 95% confidence interval: 0.705-0.934). In conclusion, rosiglitazone reduces breast cancer risk in female patients with type 2 diabetes mellitus, which shows a significant interaction with metformin.
本研究调查了罗格列酮是否会影响台湾2型糖尿病女性患者患乳腺癌的风险。从国民健康保险中检索了1996年至2009年所有接受口服降糖药或胰岛素治疗的2型糖尿病女性患者的报销数据库。设定入组日期为2006年1月1日，共对431447名患者进行随访，直至2009年底观察乳腺癌发病率。计算了罗格列酮的既往使用者、从未使用者以及剂量反应参数亚组（累积持续时间和累积剂量的三分位数切点）的发病率，并通过Cox回归估计风险比。既往使用者有53029人，从未使用者有378418人，乳腺癌发病例数分别为410例（0.77%）和3292例（0.87%），发病率分别为每100000人年217.53例和249.12例。在完全调整模型中，总体风险比为0.889（95%置信区间：0.797 - 0.992）。与从未使用者相比，累积持续时间第三三分位数（>14个月）和累积剂量第三三分位数（>1792 mg）的风险显著降低，调整后的风险比分别为0.815（95%置信区间：0.682 - 0.973）和0.815（95%置信区间：0.682 - 0.974）。此外，观察到二甲双胍与罗格列酮之间存在显著的相互作用。同时使用两种药物的患者风险最低（风险比0.812，95%置信区间：0.705 - 0.934）。总之，罗格列酮可降低2型糖尿病女性患者患乳腺癌的风险，且与二甲双胍存在显著的相互作用。
