Hsu Shu-Hua, Syu De-Kai, Wang Yu-Chiao, Liu Chih-Kuang, Chen Ming-Chih
Department of Family Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City 243, Taiwan.
Department of Orthopedics, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City 243, Taiwan.
J Clin Med. 2022 Jul 31;11(15):4469. doi: 10.3390/jcm11154469.
In the last few years, the incidence of colorectal cancer (CRC) in women has gradually increased. However, epidemiological studies on the relationship between type II diabetes mellitus (T2DM) and female CRC and the effect of metformin or statins on female CRC are insufficient. To determine their association, we conducted a population-based cohort study on women in Taiwan. We collected data on a total of 396,521 women aged 40 to 64 years old from 1 January 2007 to 31 December 2009 from the National Health Insurance Research Database. We followed up on all participants in the cohort until the occurrence of CRC, the date for all death, or 31 December 2015. Full development of CRC was identified using the International Classification of Disease (ICD), 9th Revision, code 153. We estimated hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) using the Cox proportional hazards model. Both metformin (adjusted hazard ratio, aHR = 1.12; 95% CI: 0.934-1.335, = 0.227) and statin (aHR = 1.03; 95% CI: 0.906-1.172, = 0.645) use showed no association with female CRC in a multivariate analysis. The findings indicate that metformin and statin use showed no protective effect against female colorectal cancer (CRC). An additional randomized trial is necessary to investigate the effect of metformin and statin use in CRC prevention.
在过去几年中，女性结直肠癌（CRC）的发病率逐渐上升。然而，关于2型糖尿病（T2DM）与女性CRC之间关系以及二甲双胍或他汀类药物对女性CRC影响的流行病学研究尚不充分。为了确定它们之间的关联，我们在台湾对女性进行了一项基于人群的队列研究。我们从国民健康保险研究数据库中收集了2007年1月1日至2009年12月31日期间共396,521名年龄在40至64岁之间女性的数据。我们对队列中的所有参与者进行随访，直至发生CRC、所有死亡日期或2015年12月31日。使用国际疾病分类第九版（ICD）编码153确定CRC的完全发展情况。我们使用Cox比例风险模型估计风险比（HRs）和相应的95%置信区间（CIs）。在多变量分析中，二甲双胍（调整后风险比，aHR = 1.12；95% CI：0.934 - 1.335，P = 0.227）和他汀类药物（aHR = 1.03；95% CI：0.906 - 1.172，P = 0.645）的使用均与女性CRC无关联。研究结果表明，使用二甲双胍和他汀类药物对女性结直肠癌（CRC）没有保护作用。有必要进行额外的随机试验来研究使用二甲双胍和他汀类药物在CRC预防中的效果。
