Department of Oncology and Radiotherapy, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 50, 90029, Oulu, Finland.
Department of Obstetrics and Gynaecology, PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu and University Hospital of Oulu, P.O. Box 23, 90029, Oulu, Finland.
Breast Cancer Res Treat. 2019 Jun;175(3):741-748. doi: 10.1007/s10549-019-05185-0. Epub 2019 Mar 20.
To address the possible association between the use of metformin, other forms of antidiabetic medication (ADM) and statins with the incidence of breast cancer in women with type 2 diabetes (T2D).
Data were collected from a Finnish nationwide diabetes database (FinDM). The study cohort consisted of women diagnosed with T2D in 1996-2011 in Finland. In full-cohort analysis, Poisson regression was used to estimate hazard ratios (HRs) in relation to use of metformin, insulin, other forms of oral ADM and statins. In nested case-control analysis, up to 20 controls were matched for age and duration of diabetes to each case of breast cancer. Conditional logistic regression was used to estimate HRs in relation to medication use and cumulative use of different forms of ADM, and statins.
2300 women were diagnosed with breast cancer during follow-up. No difference in breast cancer incidence was observed between metformin users [HR 1.02, 95% confidence interval (CI) 0.93-1.11] or statin users (HR 0.97, 95% CI 0.89-1.05) compared with non-users. In nested case-control analysis the results were similar. Use of insulin (HR 1.18, 95% CI 1.03-1.36) was associated with a slightly increased incidence of breast cancer.
No evidence of an association between the use of metformin or statins and the incidence of breast cancer in women with T2D was found. Among insulin users, a slightly higher incidence of breast cancer was observed.
探讨二甲双胍、其他类型降糖药物（ADM）和他汀类药物的使用与 2 型糖尿病（T2D）女性乳腺癌发病风险之间的可能关联。
数据来自芬兰全国糖尿病数据库（FinDM）。研究队列包括 1996 年至 2011 年期间在芬兰被诊断为 T2D 的女性。在全队列分析中，使用泊松回归估计与二甲双胍、胰岛素、其他类型口服 ADM 和他汀类药物使用相关的风险比（HR）。在巢式病例对照分析中，每例乳腺癌病例匹配最多 20 名年龄和糖尿病病程相匹配的对照。使用条件 logistic 回归估计与药物使用以及不同类型 ADM 和他汀类药物累积使用相关的 HR。
在随访期间，有 2300 名女性被诊断患有乳腺癌。与未使用者相比，二甲双胍使用者（HR 1.02，95%置信区间 [CI] 0.93-1.11）或他汀类药物使用者（HR 0.97，95% CI 0.89-1.05）的乳腺癌发病率没有差异。巢式病例对照分析的结果也相似。胰岛素的使用（HR 1.18，95% CI 1.03-1.36）与乳腺癌发病率的略微增加相关。
在 T2D 女性中，没有发现二甲双胍或他汀类药物的使用与乳腺癌发病风险之间存在关联的证据。在胰岛素使用者中，观察到乳腺癌的发病率略高。
