Background

Metformin and statins may have anticancer effects, with plausible cellular mechanisms. However, the association of these agents with the risk of colorectal cancer is unclear.

Patients and Methods

This was a retrospective cohort study on a large population (N = 316,317) of patients with type 2 diabetes. Data were obtained from the Diabetes in Finland database (FinDM). In a full cohort analysis, hazard ratios (HRs) with their 95% confidence intervals (CIs) for ever use versus never use were estimated using a multiple Poisson regression model. A nested case–control design within the cohort was used to examine the association of colon cancer (CC) with the defined daily dose of medication. The data were analyzed by conditional logistic regression. The analyses were adjusted for the patient’s age, sex, and duration of diabetes.

Results

In total, 1351 CC cases were diagnosed during 1996-2011. The results revealed insufficient evidence for an association between metformin (HR, 1.01; 95% CI, 0.90-1.14), other oral antidiabetic medications (HR, 1.05; 95% CI, 0.93-1.19), insulin (HR, 1.02; 95% CI, 0.86-1.22), or statins (HR, 0.94; 95% CI, 0.84-1.05) and the incidence of CC in the full cohort analysis. The results from the case–control study were similar, with no consistent trend in the incidence of CC according to the cumulative dose of metformin or the other studied medications.

Conclusion

This study found insufficient evidence for an association between metformin, insulin, other oral type 2 diabetes medications, or statins and the incidence of CC.

中文翻译：

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二甲双胍、其他抗糖尿病药物和他汀类药物与 2 型糖尿病患者结肠癌发病率的关联

背景

二甲双胍和他汀类药物可能具有抗癌作用，具有合理的细胞机制。然而，这些药物与结直肠癌风险的关联尚不清楚。

患者和方法

这是一项针对大量 2 型糖尿病患者（N = 316,317）的回顾性队列研究。数据来自芬兰糖尿病数据库 (FinDM)。在完整的队列分析中，使用多元 Poisson 回归模型估计了风险比 (HR) 及其 95% 置信区间 (CI) 与从未使用过的情况。队列中的嵌套病例对照设计用于检查结肠癌 (CC) 与确定的每日药物剂量之间的关联。通过条件逻辑回归分析数据。根据患者的年龄、性别和糖尿病病程对分析进行了调整。

结果

1996-2011 年共诊断出 1351 例 CC 病例。结果显示，二甲双胍（HR，1.01；95% CI，0.90-1.14）、其他口服降糖药（HR，1.05；95% CI，0.93-1.19）、胰岛素（HR，1.02；95%）之间存在关联的证据不足CI，0.86-1.22）或他汀类药物（HR，0.94；95% CI，0.84-1.05）和完整队列分析中 CC 的发生率。病例对照研究的结果相似，根据二甲双胍或其他研究药物的累积剂量，CC 的发生率没有一致的趋势。

结论

该研究发现二甲双胍、胰岛素、其他口服 2 型糖尿病药物或他汀类药物与 CC 发病率之间存在关联的证据不足。