Department of Pathology, Sichuan Science City Hospital, Mianyang, 621000, Sichuan, China.
Department of Pharmacy, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, 621000, Sichuan, China.
Int J Colorectal Dis. 2020 May;35(5):827-835. doi: 10.1007/s00384-020-03539-5. Epub 2020 Feb 25.
To evaluate the effect of metformin as a treatment for the mortality of colorectal cancer (CRC) patients with type 2 diabetes mellitus (T2DM).
We searched Medline, PubMed, EMBASE, Clinical Trials.gov (http://www.clinicaltrials.gov), and the Cochrane Collaboration Library from inception to November 2019. To analyze the relationship between metformin and the overall mortality, specific mortality, and sex differences in CRC patients with T2DM, hazard ratios (HRs) with 95% confidence intervals (CIs) were used. Egger's test and Begg's test were used to assess publication bias.
We included 8 cohort studies in our meta-analysis. CRC patients with T2DM treated with metformin had a lower overall mortality than CRC patients with T2DM who did not receive metformin (HR = 0.80, 95% CI 0.67-0.95). There was no significant difference in CRC-specific mortality between CRC patients with T2DM who used metformin and those who did not (HR = 0.84, 95% CI 0.65-1.08). However, females had a lower CRC-specific mortality among CRC patients with T2DM than males (HR = 0.63, 95% CI 0.41-0.97).
Metformin reduced the overall mortality of CRC patients with T2DM. Moreover, female CRC patients with T2DM using metformin had lower CRC-specific mortality than male CRC patients with T2DM.
评估二甲双胍治疗 2 型糖尿病（T2DM）合并结直肠癌（CRC）患者死亡的效果。
我们检索了 Medline、PubMed、EMBASE、ClinicalTrials.gov（http://www.clinicaltrials.gov）和 Cochrane 协作图书馆，检索时间从建库至 2019 年 11 月。为了分析二甲双胍与 T2DM 合并 CRC 患者的总死亡率、特定死亡率和性别差异之间的关系，我们使用了风险比（HR）及其 95%置信区间（CI）。采用 Egger 检验和 Begg 检验评估发表偏倚。
我们的荟萃分析纳入了 8 项队列研究。与未使用二甲双胍的 T2DM 合并 CRC 患者相比，使用二甲双胍的 T2DM 合并 CRC 患者的总死亡率更低（HR=0.80，95%CI 0.67-0.95）。使用二甲双胍的 T2DM 合并 CRC 患者与未使用二甲双胍的 T2DM 合并 CRC 患者的 CRC 特异性死亡率无显著差异（HR=0.84，95%CI 0.65-1.08）。然而，女性 T2DM 合并 CRC 患者的 CRC 特异性死亡率低于男性（HR=0.63，95%CI 0.41-0.97）。
二甲双胍降低了 T2DM 合并 CRC 患者的总死亡率。此外，使用二甲双胍的女性 T2DM 合并 CRC 患者的 CRC 特异性死亡率低于男性 T2DM 合并 CRC 患者。
