Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China.
Department of Endocrinology and Metabolism, Beijing Airport Hospital, Beijing, China.
Front Endocrinol (Lausanne). 2020 Dec 23;11:541699. doi: 10.3389/fendo.2020.541699. eCollection 2020.
Whether hypoglycemic treatments with weight-alternating effects influence the incidence of neoplasm in type 2 diasbetes (T2D) remains uncertain. Therefore, we performed a meta-analysis to assess the association between the weight alteration and incidence of neoplasm in patients with T2D.
Systematic searches were conducted for studies published between the inception of 1950s and September 2019. Randomized controlled trials conducted in T2D patients with at least 48-week follow-up, significant weight change difference between treatment arms and reports of neoplasm events were included. Fixed-effects model and meta-regression analysis were accordingly used.
In all, 46 studies were included. Analysis indicated weight reduction was not associated with a decreased incidence of neoplasm (OR = 1.01, 95% CI, 0.96 to 1.07, = 17%) and weight elevation was not associated with an increased incidence of neoplasm (OR = 0.91, 95% CI, 0.76 to 1.09, = 0%). Meta-regression analysis showed a slower weight reduction rate (β = -5.983, 95% CI, -11.412 to 0.553, = 0.03) instead of weight change difference (β = -0.030, 95% CI, -0.068 to 0.007, = 0.115) was significantly associated with reduced risk of neoplasm in patients with T2D. Moreover, a decreased incidence of prostate, bladder, and uterine neoplasm was observed in T2D patients with weight reduction difference while an increased incidence of thyroid neoplasm was found in glucagon-like peptide-1 receptor analog (GLP-1RA) users with weight reduction difference.
Additional weight change achieved by current hypoglycemic agents or strategies in short and medium periods was not associated with incidence of most neoplasm in patients with T2D. However, a decreased incidence of prostate, bladder, and uterine neoplasm was shown in T2D patients with weight reduction difference while an increased risk of thyroid neoplasm was observed in T2D patients on GLP-1RA treatments with weight reduction difference. A more sustained and persistent weight reduction process may confer reduced risk of neoplasm in patients with T2D.
具有体重变化作用的降糖治疗是否会影响 2 型糖尿病（T2D）患者的肿瘤发病率尚不确定。因此，我们进行了一项荟萃分析，以评估 T2D 患者体重变化与肿瘤发病率之间的关系。
系统检索了 20 世纪 50 年代初至 2019 年 9 月发表的研究。纳入了至少随访 48 周、治疗组之间体重变化差异显著且报告有肿瘤事件的 T2D 患者的随机对照试验。采用固定效应模型和荟萃回归分析。
共纳入 46 项研究。分析表明，体重减轻与肿瘤发病率降低无关（OR=1.01，95%CI，0.96 至 1.07， = 17%），体重增加与肿瘤发病率升高无关（OR=0.91，95%CI，0.76 至 1.09， = 0%）。荟萃回归分析显示，体重减轻率较慢（β=-5.983，95%CI，-11.412 至 0.553， = 0.03）而不是体重变化差异（β=-0.030，95%CI，-0.068 至 0.007， = 0.115）与 T2D 患者肿瘤发病风险降低显著相关。此外，在 T2D 患者中，体重减轻差异与前列腺、膀胱和子宫肿瘤发病率降低相关，而在 GLP-1RA 使用者中，体重减轻差异与甲状腺肿瘤发病率升高相关。
短期内应用当前降糖药物或策略使体重进一步变化与 T2D 患者的大多数肿瘤发病率无关。然而，在 T2D 患者中，体重减轻差异与前列腺、膀胱和子宫肿瘤发病率降低相关，而在 GLP-1RA 治疗的 T2D 患者中，体重减轻差异与甲状腺肿瘤风险增加相关。更持续和持久的体重减轻过程可能会降低 T2D 患者的肿瘤发病风险。
