Department of Community Nutrition, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Psychology, University of Bologna, Bologna, Italy.
Clin Transl Oncol. 2020 Jan;22(1):37-49. doi: 10.1007/s12094-019-02108-9. Epub 2019 Apr 22.
Breast cancer is a leading cause of cancer mortality in developed countries. We performed a meta-analysis of randomized clinical trials to investigate the effect of metformin on biomarkers associated with breast cancer outcomes and to explore the dose-response relationship.
A systematic search was performed from onset of the database to January 2019 in MEDLINE/PubMed, SCOPUS, and Cochrane library to identify randomized clinical trials investigating the impact of metformin on insulin, glucose, CRP, leptin, body mass indices (BMI), cholesterol, Ki-67, and Homeostatic Model Assessment for Insulin-Resistance (HOMA-IR). Effect sizes were expressed as weighted mean difference (WMD) and 95% confidence intervals (CI) using a random-effects models.
Nine studies providing 1,363 participants were included in the meta-analysis. Pooled results showed a significant reduction in insulin (WMD: - 0.99 U/ml, 95% CI - 1.66, - 0.33), glucose (WMD: - 1.78 ml/dl, 95% CI - 2.96, - 0.60), CRP (WMD: - 0.60 mg/l, 95% CI - 0.88, - 0.33), HOMA-IR (WMD: - 0.45, 95% CI - 0.77, - 0.11), leptin (WMD: - 2.44 ng/ml, 95% CI - 3.28, - 1.61), BMI (WMD: - 0.55 kg/m, 95% CI - 1.00, - 0.11), and Ki-67 (WMD: - 4.06, 95% CI - 7.59, - 0.54). Results of the subgroup analyses showed that insulin, glucose, and BMI decreased more significantly when the duration of administering metformin intervention was above 4 weeks. We did not observe non-linear changes in the dose-response relationship between metformin and biomarkers as outcomes.
Breast cancer patients receiving metformin as treatment for diabetes showed significant reduction in levels of insulin, fasting glucose, CRP, HOMA, leptin, BMI, and Ki-67.
乳腺癌是发达国家癌症死亡的主要原因。我们对随机临床试验进行了荟萃分析，以研究二甲双胍对与乳腺癌结局相关的生物标志物的影响，并探讨剂量反应关系。
从数据库开始到 2019 年 1 月，在 MEDLINE/PubMed、SCOPUS 和 Cochrane 图书馆中进行系统检索，以确定研究二甲双胍对胰岛素、葡萄糖、CRP、瘦素、体重指数（BMI）、胆固醇、Ki-67 和稳态模型评估的胰岛素抵抗（HOMA-IR）影响的随机临床试验。使用随机效应模型，效应大小表示为加权均数差（WMD）和 95%置信区间（CI）。
纳入了 9 项研究，共 1363 名参与者，进行了荟萃分析。汇总结果表明，胰岛素（WMD：-0.99 U/ml，95%CI-1.66，-0.33）、葡萄糖（WMD：-1.78 ml/dl，95%CI-2.96，-0.60）、CRP（WMD：-0.60 mg/l，95%CI-0.88，-0.33）、HOMA-IR（WMD：-0.45，95%CI-0.77，-0.11）、瘦素（WMD：-2.44 ng/ml，95%CI-3.28，-1.61）、BMI（WMD：-0.55 kg/m，95%CI-1.00，-0.11）和 Ki-67（WMD：-4.06，95%CI-7.59，-0.54）显著降低。亚组分析结果表明，当给予二甲双胍干预的持续时间超过 4 周时，胰岛素、葡萄糖和 BMI 降低更为显著。我们没有观察到二甲双胍与生物标志物作为结局之间的剂量反应关系呈非线性变化。
接受二甲双胍治疗糖尿病的乳腺癌患者胰岛素、空腹血糖、CRP、HOMA、瘦素、BMI 和 Ki-67 水平显著降低。
