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他汀类药物暴露与胰腺癌发病风险:一项日本区域性基于人群的队列研究,即静冈研究。

Statin Exposure and Pancreatic Cancer Incidence: A Japanese Regional Population-Based Cohort Study, the Shizuoka Study.

机构信息

Shizuoka General Hospital, Shizuoka City, Shizuoka, Japan.

Department of Endocrinology, Metabolism and Nephrology, School of Medicine, Keio University, Tokyo, Japan.

出版信息

Cancer Prev Res (Phila). 2021 Sep;14(9):863-872. doi: 10.1158/1940-6207.CAPR-21-0123. Epub 2021 Jul 9.

Abstract

Preclinical studies suggest that statins contribute to the prevention of pancreatic cancer; however, the results of epidemiologic studies are inconsistent. Furthermore, sufficient data are unavailable for the general population of Asia. Here, we conducted an observational study using a comprehensive patient-linked, longitudinal health insurance database comprising the records of 2,230,848 individuals residing in Shizuoka Prefecture, Japan, from April 2012 to September 2018. We included individuals older than 40 years with data for medical examinations and statin exposure (≥365 statin prescription days). To balance baseline characteristics between the statin exposure and statin nonexposure groups, we used inverse probability of treatment propensity score weighting method. We estimated hazard ratios for associations with pancreatic cancer using the Cox proportional hazards regression model. Among 2,230,848 individuals, we included 100,537 in the statin exposure group (24%) and 326,033 in the statin nonexposure group (76%). Among the statin exposure group (352,485 person-years) and the statin nonexposure group (1,098,463 person-years), 394 (1.12 per 1,000 person-years) and 1176 (1.07 per 1,000 person-years) developed pancreatic cancer, respectively ( = 0.464). After adjustments using inverse probability of treatment weighting, the statin exposure group was associated with a decreased incidence of pancreatic cancer (hazard ratio, 0.84; 95% confidence intervals, 0.72-0.99; = 0.036). In conclusion, the current Japanese regional population-based cohort study shows that statin exposure was associated with a lower incidence of pancreatic cancer. PREVENTION RELEVANCE: This study may support the possible role of statins in preventing pancreatic cancer in the general population in Japan.

摘要

临床前研究表明,他汀类药物有助于预防胰腺癌;然而,流行病学研究的结果并不一致。此外,亚洲普通人群的相关数据不足。在这里,我们利用一个包含 2230848 名居住在日本静冈县的个体的全面患者关联、纵向健康保险数据库进行了一项观察性研究,该数据库包含 2012 年 4 月至 2018 年 9 月的记录。我们纳入了年龄在 40 岁以上且有体检和他汀类药物暴露(≥365 天他汀类药物处方)数据的个体。为了平衡他汀类药物暴露组和他汀类药物无暴露组之间的基线特征,我们使用了逆概率处理倾向评分加权法。我们使用 Cox 比例风险回归模型估计了与胰腺癌相关的风险比。在 2230848 名个体中,我们纳入了他汀类药物暴露组(24%)的 100537 人和他汀类药物无暴露组(76%)的 326033 人。在他汀类药物暴露组(352485 人年)和他汀类药物无暴露组(1098463 人年)中,分别有 394 人和 1176 人发生了胰腺癌( = 0.464)。在校正逆概率处理倾向评分后,他汀类药物暴露组与胰腺癌发病率降低相关(风险比,0.84;95%置信区间,0.72-0.99; = 0.036)。总之,目前这项基于日本地区的人群队列研究表明,他汀类药物暴露与胰腺癌发病率降低相关。预防相关性:本研究可能支持他汀类药物在日本普通人群中预防胰腺癌的可能作用。

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