Department of Pharmacy, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan.
Pharmacoepidemiol Drug Saf. 2024 Sep;33(9):e5762. doi: 10.1002/pds.5762.
Several epidemiologic studies have revealed a higher risk of cancer in patients with diabetes mellitus (DM) relative to the general population. To investigate whether the use of acarbose was associated with higher/lower risk of new-onset cancers.
We conducted a retrospective cohort study, using a population-based National Health Insurance Research Database of Taiwan. Both inpatients and outpatients with newly onset DM diagnosed between 2000 and 2012 were collected. The Adapted Diabetes Complications Severity Index (aDCSI) was used to adjust the severity of DM. The Cox proportional hazards regression model was used to estimate the hazard ratio (HR) of disease.
A total of 22 502 patients with newly diagnosed DM were enrolled. The Cox proportional hazards regression model indicating acarbose was neutral for risk for gastroenterological malignancies, when compared to the acarbose non-acarbose users group. However, when gastric cancer was focused, acarbose-user group had significantly lowered HR than non-acarbose users group (p = 0.003). After adjusted for age, sex, cancer-related comorbidity, severity of DM, and co-administered drugs, the HR of gastric cancer risk was 0.43 (95% CI = 0.25-0.74) for acarbose-user patients.
This long-term population-based study demonstrated that acarbose might be associated with lowered risk of new-onset gastric cancer in diabetic patients after adjusting the severity of DM.
几项流行病学研究表明,与一般人群相比,糖尿病(DM)患者的癌症风险更高。为了研究阿卡波糖的使用是否与新发癌症的风险增加/降低相关。
我们进行了一项回顾性队列研究,使用了台湾基于人群的全民健康保险研究数据库。收集了 2000 年至 2012 年间新诊断为 DM 的住院和门诊患者。使用改良糖尿病并发症严重程度指数(aDCSI)调整 DM 的严重程度。使用 Cox 比例风险回归模型估计疾病的风险比(HR)。
共纳入 22502 例新诊断为 DM 的患者。Cox 比例风险回归模型表明,与阿卡波糖非阿卡波糖使用者相比,阿卡波糖对胃肠道恶性肿瘤的风险无影响。然而,当关注胃癌时,阿卡波糖使用者的 HR 明显低于非阿卡波糖使用者(p=0.003)。在校正年龄、性别、癌症相关合并症、DM 严重程度和联合用药后,阿卡波糖使用者的胃癌风险 HR 为 0.43(95%CI=0.25-0.74)。
这项长期基于人群的研究表明,在调整 DM 的严重程度后,阿卡波糖可能与糖尿病患者新发胃癌风险降低相关。