Joo Jae-Hong, Zhang Hyun-Soo, Chun Jiyeon, Park Eun-Cheol, Park Sohee
Department of Public Health, Graduate School, Yonsei University, Seoul 03722, Republic of Korea.
Institute of Health Services Research, Yonsei University, Seoul 03722, Republic of Korea.
Cancers (Basel). 2023 Aug 16;15(16):4134. doi: 10.3390/cancers15164134.
Despite the existing guideline's recommendation of metformin therapy as the initial approach for managing diabetes mellitus (DM), there remains a scarcity of comprehensive documentation regarding metformin's impact on outcomes that are important for patients.
The objective of this study was to assess the potential impact of metformin treatment on the risk of death in individuals diagnosed with both gastric cancer and pre-existing diabetes mellitus (DM); Design, Setting, and Participants: The study made use of a dataset encompassing nationwide health insurance claims, allowing for a retrospective analysis of all patients with a history of gastric cancer diagnosis (classified under International Classification of Diseases 10th Revision code: C16.X) spanning from 1 January 2002 to 31 December 2012. The primary objective was to observe death within a 5-year follow-up period. The study population comprised 63,664 individuals who fell into two categories: those treated with metformin (n = 29,548) and those who did not receive metformin treatment (n = 34,116). This classification was based on the initial treatment allocation following the diagnosis of gastric cancer.
Metformin treatment, comorbidities, concurrent medication, and procedural information.
All-cause death, disease-specific death, cardiovascular death.
During the 5-year follow-up period, the metformin treatment group exhibited a lower cumulative incidence of all-cause death (27.5%) in comparison to the group not receiving metformin treatment (32.8%). Furthermore, the relative hazards for all-cause death were significantly reduced in the metformin treatment group (HR: 0.80, 95% CI 0.78-0.82), indicating a lower risk of death when compared to the non-metformin group. In addition, metformin treatment was associated with lower occurrences of disease-specific death (related to gastric cancer) and cardiovascular death when compared to the group not undergoing metformin treatment.
The findings demonstrated that the use of metformin was effective at improving prognosis among gastric cancer patients documented with prior DM. In this population-based cohort study, metformin treatment was associated with reduced risk of mortality.
尽管现有指南推荐二甲双胍治疗作为管理糖尿病（DM）的初始方法，但关于二甲双胍对患者重要结局的影响，仍缺乏全面的文献记载。
本研究的目的是评估二甲双胍治疗对同时诊断为胃癌和既往糖尿病（DM）患者死亡风险的潜在影响；设计、设置和参与者：该研究使用了一个包含全国医疗保险索赔的数据集，以便对2002年1月1日至2012年12月31日期间所有有胃癌诊断史（根据国际疾病分类第10版代码：C16.X分类）的患者进行回顾性分析。主要目的是观察5年随访期内的死亡情况。研究人群包括63664人，分为两类：接受二甲双胍治疗的患者（n = 29548）和未接受二甲双胍治疗的患者（n = 34116）。这种分类是基于胃癌诊断后的初始治疗分配。
二甲双胍治疗、合并症、同时使用的药物和手术信息。
全因死亡、疾病特异性死亡、心血管死亡。
在5年随访期内，与未接受二甲双胍治疗的组（32.8%）相比，二甲双胍治疗组的全因死亡累积发生率较低（27.5%）。此外，二甲双胍治疗组全因死亡的相对风险显著降低（HR：0.80，95%CI 0.78 - 0.82），表明与非二甲双胍组相比死亡风险较低。此外，与未接受二甲双胍治疗的组相比，二甲双胍治疗与疾病特异性死亡（与胃癌相关）和心血管死亡的发生率较低有关。
研究结果表明，二甲双胍的使用可有效改善既往有DM记录的胃癌患者的预后。在这项基于人群的队列研究中，二甲双胍治疗与降低死亡风险相关。
