Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea.
Department of Biostatics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Sci Rep. 2018 Jun 26;8(1):9719. doi: 10.1038/s41598-018-27965-2.
This study investigated the effects of diabetes and antidiabetic medications on the risk of pancreatic cancer(PaC). We extracted data on Koreans with newly diagnosed diabetes and selected age- and sex-matched controls provided by the National Health Insurance Corporation. Incident PaC was defined as a new registration in the Korea Central Cancer Registry under ICD-10 C25 with admission history until 2015. During 19,429,617.1 person-years, 8,589 PaCs were identified in 1,005,409 subjects for diabetes group and 4,021,636 subjects for control group. The diabetes group showed more than a two-fold risk for PaC compared with the control group. Among antidiabetic medications, metformin, thiazolidinedione, and dipeptidyl peptidase-4 inhibitor exposure was associated with decreased risk for future PaC(hazard ratio[95% confidence interval] = 0.86[0.77-0.96], 0.82[0.68-0.98], 0.57[0.51-0.64], respectively), whereas sulfonylurea and insulin exposure was related to increased risk(hazard ratio[95% CI] = 1.73[1.57-1.91], 2.86[1.43-5.74], respectively) compared to subjects with no drug exposure. Moreover, subjects with dual exposure history to metformin plus thiazolidinedione or metformin plus dipeptidyl peptidase-4 inhibitor had a lower risk of PaC compared to metformin-only treated subjects. In conclusion, Korean adults with diabetes are at higher risk of PaC compared with nondiabetic individuals, and this risk may be modified by antidiabetic medications.
本研究旨在探讨糖尿病和抗糖尿病药物对胰腺癌（PaC）风险的影响。我们提取了新诊断为糖尿病的韩国患者的数据，并选择了国民健康保险公社提供的年龄和性别匹配的对照组。新发 PaC 定义为根据 ICD-10 C25 在韩国中央癌症登记处的新登记，且有 2015 年之前的住院记录。在 19,429,617.1 人年中，在 1,005,409 例糖尿病组患者和 4,021,636 例对照组患者中，共发现 8,589 例 PaC。与对照组相比，糖尿病组发生 PaC 的风险高出两倍以上。在抗糖尿病药物中，二甲双胍、噻唑烷二酮和二肽基肽酶-4 抑制剂的暴露与未来 PaC 的风险降低相关（风险比[95%置信区间] = 0.86[0.77-0.96]、0.82[0.68-0.98]、0.57[0.51-0.64]），而磺脲类药物和胰岛素的暴露与风险增加相关（风险比[95%CI] = 1.73[1.57-1.91]、2.86[1.43-5.74]），与未暴露于药物的患者相比。此外，与仅接受二甲双胍治疗的患者相比，同时暴露于二甲双胍加噻唑烷二酮或二甲双胍加二肽基肽酶-4 抑制剂的患者 PaC 风险较低。总之，与非糖尿病个体相比，韩国糖尿病成年人发生 PaC 的风险更高，而这种风险可能会因抗糖尿病药物而改变。
