Diabetes Care：糖尿病患者使用二甲双胍与患肺癌风险无关

2012年8月31日 讯 /生物谷BIOON/ -- 据8月24日在线发表在Diabetes Care杂志上的一则研究证实：与早期观察性研究结论相反，服用二甲双胍的2型糖尿病患者患肺癌的风险不会降低。

蒙特利尔犹太总医院Brielan B. Smiechowski等研究人员为了确定是否2型糖尿病使用二甲双胍与肺癌的发病率相关联，收集了115,923例服用口服降糖药治疗的2型糖尿病患者的数据进行了分析。在随访研究过程中，研究人员发现虽然有1,061例患者被诊断为肺癌，但二甲双胍对肺癌症发病率没有影响。吸烟状况对此结果无明显影响。Smiechowski和他的同事得出结论：2型糖尿病患者使用二甲双胍与患肺癌风险的降低是不相关的，研究人员认为在其他观察性研究报告报告中的得出的二甲双胍可能会降低患肺癌风险可能是由于方法上的缺陷导致的。

与二甲双胍相关的拓展阅读：

• Diabetes Care：lixisenatide有效改善二甲双胍控制不佳的2型糖尿病人群的血糖
• Am J Psychiatry：二甲双胍可治疗抗精神病药物所致不良反应
• Nature：揭示二甲双胍降糖新机制
• Diabetes Care：二甲双胍能改善心血管高危的2型糖尿病患者心血管预后（SPREAD-DIMCAD研究
• JCEM：二甲双胍降低肥胖儿童BMI和血糖水平 更多信息请点击：有关二甲双胍更多资讯

The Use of Metformin and the Incidence of Lung Cancer in Patients With Type 2 Diabetes
OBJECTIVE Observational studies have associated metformin use with a decreased risk of lung cancer incidence in patients with type 2 diabetes, but the studies had important methodological shortcomings. The objective of this study was to determine whether metformin use is associated with a decreased risk of lung cancer in patients with type 2 diabetes, while avoiding previous biases.
RESEARCH DESIGN AND METHODS Using the U.K. General Practice Research Database, we assembled a cohort of patients newly treated with oral hypoglycemic agents (OHAs) between 1988 and 2009. A nested case–control analysis was conducted, where case subjects with lung cancer occurring during follow-up were matched with up to 10 control subjects for age, sex, calendar time, and duration of follow-up. Conditional logistic regression was used to estimate adjusted rate ratios of lung cancer associated with ever use of metformin, along with measures of duration and cumulative dose. Models were adjusted for potential confounders, which included smoking.
RESULTS The cohort included 115,923 new users of OHAs, with 1,061 patients diagnosed with lung cancer during follow-up (rate 2.0/1,000 person-years). Metformin use was not associated with a decreased rate of lung cancer (rate ratio 0.94 [95% CI 0.76–1.17]). No dose-response was observed by number of prescriptions received, cumulative duration of use, and dose.
CONCLUSIONS Metformin use is not associated with a decreased risk of lung cancer in patients with type 2 diabetes. The decreased risk reported in other observational studies is likely due to bias from methodological shortcomings. Nonetheless, greater consideration should be given to clarify inconsistencies between experimental models and population studies.