Zhang LiRong, Cai Jiaqin, Lin Huiting, Wu Wenhua, Hu Congting, Lin Xinmiao, Sun Hong, Wei XiaoXia
School of Pharmacy, Fujian Medical University, Fuzhou, China.
Department of Pharmacy, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou University Affiliated Provincial Hospital, No. 134, Gulou District, Fuzhou City, 350001, Fujian Province, People's Republic of China.
Acta Diabetol. 2025 Feb;62(2):185-192. doi: 10.1007/s00592-024-02344-8. Epub 2024 Aug 17.
Previous studies have investigated the association between diabetes medications and thyroid cancer, but the results have not been conclusive. This study used a Mendelian randomization approach to investigate the causal relationship between diabetes medications and thyroid cancer (TC).
Exposures were six major diabetes medications target, while outcomes were TC and its differentiated forms, including papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC). Mendelian randomization was conducted using IVW, MR-Egger, and weighted median methods. Tests for heterogeneity, horizontal pleiotropy, and leave-one-out were also performed.
In European populations, SGLT2 inhibitors were significantly negatively associated with TC (OR 0.051, 95% CI 0.006-0.465, P = 0.0082) as well as PTC (OR 0.034, 95% CI 0.003-0.411, P = 0.0079), while no correlation was found with FTC. These findings remained consistent even after applying the Bonferroni correction.
The evidence suggests that SGLT2 inhibitors could be potential therapeutic targets for TC, especially for PTC, in European populations. However, further large-scale randomized controlled trials are necessary to verify their ability to reduce the risk of and treat these types of cancer.
既往研究探讨了糖尿病药物与甲状腺癌之间的关联,但结果尚无定论。本研究采用孟德尔随机化方法,探讨糖尿病药物与甲状腺癌(TC)之间的因果关系。
暴露因素为六种主要的糖尿病药物靶点,结局为TC及其分化型,包括乳头状甲状腺癌(PTC)和滤泡状甲状腺癌(FTC)。采用逆方差加权法(IVW)、MR-Egger回归法和加权中位数法进行孟德尔随机化分析。还进行了异质性检验、水平多效性检验和逐一剔除检验。
在欧洲人群中,钠-葡萄糖协同转运蛋白2(SGLT2)抑制剂与TC(比值比[OR]0.051,95%可信区间[CI]0.006-0.465,P = 0.0082)以及PTC(OR 0.034, 95% CI 0.003-0.411, P = 0.0079)显著负相关,而与FTC无相关性。即使应用Bonferroni校正后,这些结果仍然一致。
有证据表明,在欧洲人群中,SGLT2抑制剂可能是TC尤其是PTC的潜在治疗靶点。然而,需要进一步开展大规模随机对照试验,以验证其降低这些癌症风险和治疗这些癌症的能力。