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二甲双胍和他汀类药物在 2 型糖尿病患者上皮性卵巢癌发病中的作用:一项队列研究和巢式病例对照研究。

The role of metformin and statins in the incidence of epithelial ovarian cancer in type 2 diabetes: a cohort and nested case-control study.

机构信息

Department of Obstetrics and Gynaecology, PEDEGO Research Unit, Medical Research Centre Oulu, University of Oulu and University Hospital of Oulu, Oulu, Finland.

Children, Adolescents and Families Unit, Department of Welfare, National Institute for Health and Welfare, Oulu, Finland.

出版信息

BJOG. 2018 Jul;125(8):1001-1008. doi: 10.1111/1471-0528.15151. Epub 2018 Mar 12.

Abstract

OBJECTIVE

To obtain evidence of the effects of metformin and statins on the incidence of ovarian cancer in women with type 2 diabetes (T2D).

DESIGN

A retrospective cohort study and nested case-control study.

SETTING

The data were obtained from a diabetes database (FinDM) combining information from several nationwide registers.

POPULATION

A cohort of 137 643 women over 40 years old and diagnosed with T2D during 1996-2011 in Finland.

METHODS

In full cohort analysis Poisson regression was used to estimate the hazard ratios (HR) in relation to ever use of metformin, insulin other oral anti-diabetic medication or statins. In the nested case-control analysis 20 controls were matched to each case of ovarian cancer. Conditional logistic regression was used to estimate HRs in relation to medication use and cumulative use of different medications. The estimates were adjusted for age and duration of T2D.

MAIN OUTCOME MEASURE

Incidence of ovarian cancer.

RESULTS

In all, 303 women were diagnosed with ovarian cancer during the follow up. Compared with other forms of oral anti-diabetic medication, metformin (HR 1.02, 95% CI: 0.72-1.45) was not found to be associated with the incidence of ovarian cancer. Neither was there evidence for statins to affect the incidence (HR 0.99, 95% CI: 0.78-1.25). In nested case-control analysis the results were essentially similar.

CONCLUSIONS

No evidence of an association between the use of metformin or statins and the incidence of ovarian cancer in women with T2D was found.

TWEETABLE ABSTRACT

No evidence found for metformin or statins reducing the incidence of ovarian cancer.

摘要

目的

探讨二甲双胍和他汀类药物对 2 型糖尿病(T2D)女性卵巢癌发病的影响。

设计

回顾性队列研究和巢式病例对照研究。

地点

数据来自一个结合了多个全国性登记处信息的糖尿病数据库(FinDM)。

人群

芬兰年龄在 40 岁以上、1996 年至 2011 年间被诊断为 T2D 的 137643 名女性队列。

方法

在全队列分析中,采用泊松回归估计与二甲双胍、胰岛素或其他口服降糖药或他汀类药物的使用相关的风险比(HR)。在巢式病例对照分析中,20 名对照与每例卵巢癌病例匹配。采用条件逻辑回归估计与药物使用和不同药物累积使用相关的 HR。这些估计值根据年龄和 T2D 的持续时间进行了调整。

主要观察指标

卵巢癌的发病率。

结果

在随访期间,共有 303 名女性被诊断患有卵巢癌。与其他类型的口服降糖药相比,二甲双胍(HR1.02,95%CI:0.72-1.45)与卵巢癌的发病率无关。也没有证据表明他汀类药物会影响卵巢癌的发病率(HR0.99,95%CI:0.78-1.25)。在巢式病例对照分析中,结果基本相似。

结论

在 T2D 女性中,没有发现使用二甲双胍或他汀类药物与卵巢癌发病率之间存在关联的证据。

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