钠-葡萄糖协同转运蛋白2抑制剂与新发癌症的关联。

Association of SGLT2 inhibitors with incident cancer.

作者信息

Suzuki Yuta, Kaneko Hidehiro, Okada Akira, Ko Toshiyuki, Jimba Takahiro, Fujiu Katsuhito, Takeda Norifumi, Morita Hiroyuki, Komuro Jin, Ieda Masaki, Node Koichi, Komuro Issei, Yasunaga Hideo, Takeda Norihiko

机构信息

The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan; Center for Outcomes Research and Economic Evaluation for Health, National Institute of Public Health, Saitama, Japan.

The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan; The Department of Advanced Cardiology, The University of Tokyo, Tokyo, Japan.

出版信息

Diabetes Metab. 2024 Nov;50(6):101585. doi: 10.1016/j.diabet.2024.101585. Epub 2024 Oct 24.

DOI:10.1016/j.diabet.2024.101585

PMID:39455021

Abstract

AIM

It remains unknown whether sodium-glucose cotransporter 2 inhibitors (SGLT2i) could be associated with incident cancer.

METHODS

We analyzed individuals having diabetes and newly prescribed SGLT2i or dipeptidyl peptidase 4 inhibitors (DPP4i) in a large-scale epidemiological database. The primary outcome was the incidence of cancer. A propensity score matching algorithm was employed to compare the subsequent development of cancer between the SGLT2i and DPP4i groups.

RESULTS

After 1:2 propensity score matching, 26,823 individuals (8,941 SGLT2i, 17,882 DPP4i) were analyzed. During the mean follow-up duration of 2.0 ± 1.6 years, 1,076 individuals developed cancer. SGLT2i administration was associated with a reduced risk of cancer (HR 0.80, 95 % CI 0.70-0.91). Particularly, SGLT2i administration was related to a lower risk of colorectal cancer (HR 0.71, 95 % CI 0.50-0.998). Our primary findings remained consistent across various sensitivity analyses, including overlap weighting analysis (HR 0.79, 95 % CI 0.66-0.94), inverse probability of treatment weighting 0.75 (95 % CI 0.65-0.86), and induction period settings 0.78 (95 % CI 0.65-0.93). The risk of developing cancer was comparable among individual SGLT2is (P-value of 0.1738).

CONCLUSION

Our investigation using nationwide real-world data demonstrated the potential advantage of SGLT2i over DPP4i in reducing the development of cancer in individuals with diabetes.

摘要

目的

钠-葡萄糖协同转运蛋白2抑制剂（SGLT2i）是否与新发癌症相关仍不清楚。

方法

我们在一个大规模流行病学数据库中分析了患有糖尿病且新开具SGLT2i或二肽基肽酶4抑制剂（DPP4i）的个体。主要结局是癌症发病率。采用倾向评分匹配算法比较SGLT2i组和DPP4i组后续癌症的发生情况。

结果

经过1:2倾向评分匹配后，分析了26,823名个体（8,941名使用SGLT2i，17,882名使用DPP4i）。在平均2.0±1.6年的随访期间，1,076名个体患癌。使用SGLT2i与降低癌症风险相关（风险比0.80，95%置信区间0.70-0.91）。特别是，使用SGLT2i与较低的结直肠癌风险相关（风险比0.71，95%置信区间0.50-0.998）。我们的主要发现通过各种敏感性分析保持一致，包括重叠加权分析（风险比0.79，95%置信区间0.66-0.94）、治疗逆概率加权分析（风险比0.75，95%置信区间0.65-0.86）和诱导期设定分析（风险比0.78，95%置信区间0.65-0.93）。各SGLT2i之间患癌风险相当（P值为0.1738）。