Wu Xiao-Qing, Deng Li-Hua, Xue Qian, Li Xia, Li Meng-Han, Wang Jing-Tong
Department of Geriatrics, Peking University People's Hospital, Beijing 100044, China.
World J Clin Cases. 2024 Jul 16;12(20):4206-4216. doi: 10.12998/wjcc.v12.i20.4206.
Colorectal polyps are frequently observed in patients with type 2 diabetes mellitus (DM), posing a significant risk for colorectal cancer. Metformin, a widely prescribed biguanidine drug for type 2 DM, has been suggested to have potential chemoprophylactic effects against various cancers.
To explore the correlation between colorectal polyps and metformin use in type 2 DM patients.
Type 2 DM patients were categorized into polyp and non-polyp groups. Following this, all patients were categorized into the type 2 DM-metformin, type 2 DM-non-metformin, and non-type 2 DM groups. Based on the baseline colonoscopy results, we performed pairwise comparisons of the incidence of colorectal polyps among the three groups. Additionally, we analyzed the relationship between colorectal polyps and the duration of metformin use and between the size and number of polyps and metformin use. Simultaneously, we focused on the specific pathological types of polyps and analyzed their relationship with metformin use. Finally, we compared the incidence of polyps between metformin and non-metformin groups according to the interval colonoscopy results.
The rate of metformin use in patients with colorectal polyps was 0.502 times that of patients without colorectal polyps [odds ratio (OR) = 0.502, 95% confidence interval (CI): 0.365-0.689; < 0.001]. The incidence of colorectal polyps did not differ significantly between the type 2 DM-metformin and non-type 2 DM groups ( > 0.05). Furthermore, the correlations between the duration of metformin use and the incidence of colorectal polyps and between the size and number of polyps and metformin use were not statistically significant ( > 0.05). Metformin use did not affect the incidence of colorectal polyps during interval colonoscopy ( > 0.05).
Metformin use and colorectal polyp incidence in type 2 DM patients showed a negative correlation, independent of the hypoglycemic effect of metformin.
2型糖尿病（DM）患者中经常观察到结直肠息肉，这对结直肠癌构成了重大风险。二甲双胍是一种广泛用于治疗2型糖尿病的双胍类药物，已被认为对各种癌症具有潜在的化学预防作用。
探讨2型糖尿病患者结直肠息肉与二甲双胍使用之间的相关性。
将2型糖尿病患者分为息肉组和非息肉组。随后，将所有患者分为2型糖尿病-二甲双胍组、2型糖尿病-非二甲双胍组和非2型糖尿病组。根据基线结肠镜检查结果，我们对三组患者结直肠息肉的发生率进行了两两比较。此外，我们分析了结直肠息肉与二甲双胍使用时长之间的关系，以及息肉大小、数量与二甲双胍使用之间的关系。同时，我们关注息肉的具体病理类型，并分析它们与二甲双胍使用的关系。最后，根据间隔期结肠镜检查结果比较二甲双胍组和非二甲双胍组息肉的发生率。
结直肠息肉患者使用二甲双胍的比例是无结直肠息肉患者的0.502倍[比值比（OR）=0.502，95%置信区间（CI）：0.365 - 0.689；P<0.001]。2型糖尿病-二甲双胍组和非2型糖尿病组之间结直肠息肉的发生率无显著差异（P>0.05）。此外，二甲双胍使用时长与结直肠息肉发生率之间，以及息肉大小、数量与二甲双胍使用之间的相关性均无统计学意义（P>0.05）。在间隔期结肠镜检查期间，使用二甲双胍并不影响结直肠息肉的发生率（P>0.05）。
2型糖尿病患者使用二甲双胍与结直肠息肉发生率呈负相关，且与二甲双胍的降糖作用无关。
