Unit for Cardiovascular Epidemiology, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Centre, Ramat Gan, Israel.
Sackler Faculty of Medicine, School of Public Health, Department of Epidemiology and Preventive Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel.
Diabet Med. 2020 Feb;37(2):194-202. doi: 10.1111/dme.14179. Epub 2020 Jan 3.
An increasing number of studies have investigated associations of antidiabetes medications with cancer risk. Antidiabetes medications are classified by their mechanisms of action on tissues and organs. They potentially act as both causative and confounding factors in the temporal association of diabetes and cancer.
To present the current evidence regarding both the carcinogenic and anti-carcinogenic effects of antidiabetes medications on cancer in humans.
A review of the scientific literature.
The most conclusive evidence shown of an association of antidiabetes medication with a specific cancer was for that of the thiazolidinedione pioglitazone with bladder cancer. Currently, there is inconclusive evidence regarding a possible association of incretin therapies, drugs of the dipeptidyl peptidase-4 inhibitor class, with the risk of pancreatic cancer. Insulin, sulfonylureas, metformin and sodium-glucose co-transporter-2 inhibitors appear not to be associated with increased risk of any cancer. Sparse evidence suggests possible protective effects against cancer incidence of metformin, sulfonylureas, thiazolidinediones, incretin-based drugs and sodium-glucose co-transporter-2 inhibitors.
The conflicting evidence regarding associations of antidiabetes medications with cancer risk is apparently attributable to both methodological issues and to the complexity of the subject. More recent and better-designed studies have weakened the evidence for links between antidiabetes medications and cancer risk.
越来越多的研究探讨了抗糖尿病药物与癌症风险之间的关联。抗糖尿病药物根据其对组织和器官的作用机制进行分类。它们可能在糖尿病和癌症的时间关联中既是致病因素，也是混杂因素。
介绍抗糖尿病药物在人类癌症中致癌和抗癌作用的现有证据。
对科学文献进行综述。
与抗糖尿病药物与特定癌症相关的最确凿证据是噻唑烷二酮吡格列酮与膀胱癌之间的关联。目前，关于肠促胰岛素治疗、二肽基肽酶-4 抑制剂类药物与胰腺癌风险之间可能存在关联的证据尚无定论。胰岛素、磺酰脲类、二甲双胍和钠-葡萄糖共转运蛋白 2 抑制剂似乎与任何癌症的风险增加无关。有限的证据表明，二甲双胍、磺酰脲类、噻唑烷二酮类、肠促胰岛素类药物和钠-葡萄糖共转运蛋白 2 抑制剂可能对癌症发病率有保护作用。
抗糖尿病药物与癌症风险之间关联的相互矛盾的证据显然归因于方法学问题和该主题的复杂性。最近和设计更好的研究削弱了抗糖尿病药物与癌症风险之间联系的证据。
