Dulskas Audrius, Patasius Ausvydas, Kaceniene Auguste, Linkeviciute-Ulinskiene Donata, Zabuliene Lina, Smailyte Giedre
Department of Abdominal and General Surgery and Oncology, National Cancer Institute, 1 Santariskiu Str., LT‑08406 Vilnius, Lithuania.
University of Applied Sciences, Faculty of Health Care, 45 Didlaukio Str., LT-08303 Vilnius, Lithuania.
J Clin Med. 2020 Feb 5;9(2):435. doi: 10.3390/jcm9020435.
We assessed gastric cancer risk in type 2 diabetes mellitus patients. Gastric cancer patients with diabetes between 2001-2012 were identified. Four groups were analysed: combination therapy with metformin users; insulin and other medication users; metformin and insulin users; and sulfonylurea users. Standardised incidence ratios (SIRs) for gastric cancers as a ratio of the observed number of cancer cases in people with diabetes to the expected number of cancer cases in the underlying general population were calculated. A total of 99,992 patients with diabetes were analysed and 337 gastric cancer cases in patients with diabetes were observed when compared to the expected number of 400.54 gastric cancer cases, according to the cancer rates of the general population (SIR 0.84, 95% confidence interval (CI): 0.76-0.94). Lower risk of gastric cancer was found both in male and female patients with diabetes, however, risk among females was insignificantly lower. Higher gastric cancer risk was found in the group of diabetic patients treated with sulfonylureas (SIR 1.31, 95% CI: 1.04-1.65) and significantly lower risk than expected from the general population was found in the group of metformin users (SIR 0.75, 95% CI: 0.66-0.86). Type 2 diabetes mellitus was not associated with increased risk of gastric cancer. Metformin might decrease the risk of gastric cancer in patients with diabetes, while sulfonylureas may increase gastric cancer risk.
我们评估了2型糖尿病患者患胃癌的风险。确定了2001年至2012年间患有糖尿病的胃癌患者。分析了四组：二甲双胍使用者联合治疗组；胰岛素及其他药物使用者组；二甲双胍和胰岛素使用者组；以及磺脲类药物使用者组。计算了胃癌的标准化发病率（SIRs），即糖尿病患者中观察到的癌症病例数与基础普通人群中预期癌症病例数的比值。共分析了99992例糖尿病患者，观察到糖尿病患者中有337例胃癌病例，而根据普通人群的癌症发病率，预期胃癌病例数为400.54例（SIR 0.84，95%置信区间（CI）：0.76 - 0.94）。发现糖尿病男性和女性患者患胃癌的风险均较低，不过女性患者的风险略低。在接受磺脲类药物治疗的糖尿病患者组中发现胃癌风险较高（SIR 1.31，95% CI：1.04 - 1.65），而在二甲双胍使用者组中发现风险显著低于普通人群预期（SIR 0.75，95% CI：0.66 - 0.86）。2型糖尿病与胃癌风险增加无关。二甲双胍可能会降低糖尿病患者患胃癌的风险，而磺脲类药物可能会增加胃癌风险。
