Najafi Farid, Rajati Fatemeh, Sarokhani Diana, Bavandpour Maryam, Moradinazar Mehdi
Research Center for Environmental Determinants of Health, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Behavioral Disease Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Int J Prev Med. 2023 Jul 15;14:90. doi: 10.4103/ijpvm.ijpvm_62_21. eCollection 2023.
Considering that metformin is widely used in the treatment of diabetes, and its protective role against various malignancies, the strength and validity of the available evidence from related systematic reviews and meta-analysis were evaluated.
Scopus, PubMed, Embase, Cochrane, Web of science databases, and Google Scholar and manual screening of retrieved references were systematically searched from their inception dates to 24 March 2020 by extracting the effect size (Odds ratios (OR) and relative risk (RR) in each study. To present the forest plot of effect of metformin on each cancer, Stata version 14.2 was used.
This study included 36 meta-analysis studies and 620 original research studies (26 randomized control trials studies and 594 observational studies (cohort, case-control)) covering 15 different cancers. Overall, metformin medication prevented different cancers, including ovarian cancer (OR = 0.76, 95% CI: 0.62,0.93), cervical cancer (OR = 0.60, 95% CI: 0.43, 0.83), endometrial cancer (OR = 1.05, 95% CI: 0.82,1.35), liver cancer (OR = 0.59, 95% CI: 0.47,0.74), pancreatic cancer (OR = 0.59, 95%CI 0.50,0.69), head and neck cancer (OR = 0.71, 95% CI: 0.61,0.83), stomach cancer (OR = 0.72, 95% CI: 0.26,1.99), colorectal cancer (OR = 0.73, 95% CI: 0.59,0.91), colorectal adenoma cancer (OR = 0.75, 95% CI: 0.65,0.86), colon cancer (OR = 0.79, 95% CI: 0.69,0.91), esophagus cancer (OR = 0.90, 95% CI: 0.83,0.98), lung cancer (OR = 0.92, CI95%:0.85,0.99), breast cancer (OR = 0.93, 95% CI: 0.84,1.02), prostate cancer (OR = 0.94, 95% CI: 0.85-1.04), and bladder cancer (OR = 0.94 95% CI: 0.64,1.38).
Treatment with metformin can significantly decrease the chance of all cancers with larger preventive effect on hepatocellular carcinoma and smaller preventive effect on lung and breast cancers.
鉴于二甲双胍广泛用于糖尿病治疗及其对各种恶性肿瘤的保护作用，对相关系统评价和荟萃分析的现有证据的强度和有效性进行了评估。
通过提取各研究中的效应量（比值比（OR）和相对风险（RR）），对Scopus、PubMed、Embase、Cochrane、Web of science数据库以及Google Scholar进行系统检索，并从其创建日期至2020年3月24日对手动筛选出的检索参考文献进行检索。为展示二甲双胍对每种癌症的效应森林图，使用了Stata 14.2版本。
本研究纳入了36项荟萃分析研究和620项原始研究（26项随机对照试验研究和594项观察性研究（队列研究、病例对照研究）），涵盖15种不同癌症。总体而言，二甲双胍用药可预防多种癌症，包括卵巢癌（OR = 0.76，95%可信区间：0.62, 0.93）、宫颈癌（OR = 0.60，95%可信区间：0.43, 0.83）、子宫内膜癌（OR = 1.05，95%可信区间：0.82, 1.35）、肝癌（OR = 0.59，95%可信区间：0.47, 0.74）、胰腺癌（OR = 0.59，95%可信区间0.50, 0.69）、头颈癌（OR = 0.71，95%可信区间：0.61, 0.83）、胃癌（OR = 0.72，95%可信区间：0.26, 1.99）、结直肠癌（OR = 0.73，95%可信区间：0.59, 0.91）、结直肠腺瘤癌（OR = 0.75，95%可信区间：0.65, 0.86）、结肠癌（OR = 0.79，95%可信区间：0.69, 0.91）、食管癌（OR = 0.90，95%可信区间：0.83, 0.98）、肺癌（OR = 0.92，95%可信区间：0.85, 0.99）、乳腺癌（OR = 0.93，95%可信区间：0.84, 1.02）、前列腺癌（OR = 0.94，95%可信区间：0.85 - 1.04）和膀胱癌（OR = 0.94，95%可信区间：0.64, 1.38）。
二甲双胍治疗可显著降低患所有癌症的几率，对肝细胞癌的预防效果较大，对肺癌和乳腺癌的预防效果较小。
