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评估β受体阻滞剂对胰腺癌风险的影响:一项巢式病例对照研究。

Assessing the effects of beta-blockers on pancreatic cancer risk: A nested case-control study.

机构信息

Department of Oncology, Sheba Medical Center, Tel-Hashomer, Israel.

Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.

出版信息

Pharmacoepidemiol Drug Saf. 2020 May;29(5):599-604. doi: 10.1002/pds.4993. Epub 2020 Mar 20.

Abstract

PURPOSE

Both β1- and β2-adrenoceptor proteins were detected on the cell surface of pancreatic ductal adenocarcinoma. The current study evaluated the association between beta-blocker use and pancreatic cancer risk.

METHODS

We conducted a nested case-control study in a large population representative database. Each pancreatic cancer case was matched with four controls based on age, sex, practice site, and duration of follow-up using incidence density sampling. Beta-blocker use was defined as any prescription prior to index date and was stratified into non-selective and selective β -blockers. The odds ratios (ORs) and 95% confidence intervals (95% CIs) for pancreatic cancer risk associated with beta-blocker use was estimated using conditional logistic regression.

RESULTS

The study included 4113 patients with pancreatic cancer and 16 072 matched controls. When compared to never users, there was no association between any beta-blocker use and pancreatic cancer risk (adjusted OR 1.06, 95% CI 0.97-1.16, P = .16). Analysis by receptor selectivity showed use of non-selective beta-blockers for more than 2 years was associated with a reduced pancreatic cancer risk (OR 0.75, 95% CI 0.57-1.00, P = .05). When compared to former users both users of selective β1-blockers and non-selective beta-blockers had a reduced pancreatic cancer risk (OR 0.78, 95% CI 0.67-0.90, P = .001) and (OR 0.67, 95% CI 0.49-0.92, P = .01), respectively.

CONCLUSION

Beta-blocker use was not associated with increased pancreatic cancer risk. However, long-term use of beta-blockers may be associated with decreased pancreatic cancer risk.

摘要

目的

β1-和β2-肾上腺素受体蛋白均存在于胰腺导管腺癌的细胞表面。本研究评估了β受体阻滞剂的使用与胰腺癌风险之间的关系。

方法

我们在一个大型人群代表性数据库中进行了一项嵌套病例对照研究。每个胰腺癌病例都根据年龄、性别、就诊地点和随访时间,通过发病率密度抽样与 4 名对照相匹配。β受体阻滞剂的使用定义为索引日期前的任何处方,并分为非选择性和选择性β受体阻滞剂。使用条件逻辑回归估计与β受体阻滞剂使用相关的胰腺癌风险的比值比(OR)和 95%置信区间(95%CI)。

结果

该研究包括 4113 例胰腺癌患者和 16072 例匹配对照。与从未使用者相比,任何β受体阻滞剂的使用与胰腺癌风险均无关联(调整后的 OR 1.06,95%CI 0.97-1.16,P=0.16)。受体选择性分析显示,使用非选择性β受体阻滞剂超过 2 年与胰腺癌风险降低相关(OR 0.75,95%CI 0.57-1.00,P=0.05)。与前使用者相比,选择性β1 受体阻滞剂和非选择性β受体阻滞剂的使用者的胰腺癌风险均降低(OR 0.78,95%CI 0.67-0.90,P=0.001)和(OR 0.67,95%CI 0.49-0.92,P=0.01)。

结论

β受体阻滞剂的使用与胰腺癌风险增加无关。然而,β受体阻滞剂的长期使用可能与胰腺癌风险降低有关。

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