Liao Kuan-Fu, Lin Cheng-Li, Lai Shih-Wei
College of Medicine, Tzu Chi University, Hualien 970, Taiwan - Division of Hepatogastroenterology, Department of Internal Medicine, Taichung Tzu Chi Hospital, Taichung 427, Taiwan.
College of Medicine, China Medical University, Taichung 404, Taiwan - Management Office for Health Data.
Biomedicine (Taipei). 2019 Mar;9(1):4. doi: 10.1051/bmdcn/2019090104. Epub 2019 Feb 22.
This study was designed to assess whether there was an association between colorectal cancer and thiazolidinediones use.
A population-based case-control study was performed using the database of the Taiwan National Health Insurance Program. The case group consisted of 20218 type 2 diabetic subjects aged 20 to 84 years with newly diagnosed colorectal cancer between 2000 and 2011. The date of a subject being diagnosed with colorectal cancer was defined as the index date. The control group consisted of 20218 randomly selected type 2 diabetic subjects aged 20 to 84 years without colorectal cancer between 2000 and 2011. A subject who had at least a prescription of thiazolidinediones before the index date was defined as "ever used". A subject who did not have a prescription of thiazolidinediones before the index date was defined as "never used". The odds ratio (OR) and 95% confidence interval (CI) was used to estimate the association between colorectal cancer and thiazolidinediones use by the multivariable logistic regression model.
After adjustment for potential confounders, the odds of thiazolidinediones use in cases with colorectal cancer were lower than the odds of thiazolidinediones use in subjects without colorectal cancer (adjusted OR 0.94, 95% CI 0.89-0.99).
The odds of thiazolidinediones use in cases with colorectal cancer were lower than subjects without colorectal cancer. A prospective study is required to test whether thiazolidinediones use has a protective effect against colorectal cancer.
本研究旨在评估结直肠癌与噻唑烷二酮类药物使用之间是否存在关联。
利用台湾全民健康保险计划的数据库进行了一项基于人群的病例对照研究。病例组由2000年至2011年间新诊断为结直肠癌的20218名20至84岁的2型糖尿病患者组成。将一名受试者被诊断为结直肠癌的日期定义为索引日期。对照组由2000年至2011年间随机选取的20218名20至84岁无结直肠癌的2型糖尿病患者组成。在索引日期之前至少有一次噻唑烷二酮类药物处方的受试者被定义为“曾经使用过”。在索引日期之前没有噻唑烷二酮类药物处方的受试者被定义为“从未使用过”。采用多变量逻辑回归模型，用比值比（OR）和95%置信区间（CI）来估计结直肠癌与噻唑烷二酮类药物使用之间的关联。
在对潜在混杂因素进行调整后，结直肠癌患者使用噻唑烷二酮类药物的几率低于无结直肠癌患者使用噻唑烷二酮类药物的几率（调整后的OR为0.94，95%CI为0.89-0.99）。
结直肠癌患者使用噻唑烷二酮类药物的几率低于无结直肠癌的患者。需要进行前瞻性研究来检验噻唑烷二酮类药物的使用是否对结直肠癌有保护作用。
