二甲双胍与2型糖尿病患者大肠癌发病风险关系的Meta分析  

Metformin as a risk factor of pathogenesis of colorectal cancer in type 2 diabetes patients: a Metaanalysis

作　　者：颜英[1] 汤绍辉[1] 黄秋燕[1] 汤慧君[1] 

机构地区：[1]暨南大学附属第一医院消化内科,广州510630

出　　处：《解放军医学杂志》2015年第7期582-586,共5页Medical Journal of Chinese People's Liberation Army

摘　　要：目的系统评价二甲双胍与2型糖尿病患者大肠癌发病风险之间的关系。方法检索建库至2014年11月Pub Med、Embase、Medline、Cochrane Library、中国知网、万方数据库及维普数据库（VIP）中关于2型糖尿病患者使用二甲双胍治疗与大肠癌发病风险之间关系的队列研究或病例对照研究,采用Rev Man 5.2统计软件进行Meta分析。采用Newcastle-Ottaua Scale（NOS）评分标准对纳入文献进行质量评估。结果共11篇文献符合纳入标准,其中8篇为队列研究,共包括12个研究,纳入447 234例患者,另3篇为病例对照研究,纳入24 032例患者。Meta分析结果如下：队列研究合并结果显示,与其他降糖药物相比,二甲双胍治疗可使2型糖尿病患者大肠癌发病风险降低30%（RR=0.70,95%CI 0.58~0.85,P=0.0002）;病例对照研究合并结果显示,2型糖尿病患者使用二甲双胍治疗可降低大肠癌发病风险（OR=0.78,95%CI 0.71~0.86,P〈0.00001）。结论二甲双胍治疗可降低2型糖尿病患者罹患大肠癌的风险。Objective To evaluate the association between metformin therapy and the risk of pathogenesis of colorectal cancer in patients with type 2 diabetes. Methods Pub Med, Embase, Medline, the Cochrane Library, China National Knowledge Infrastructure（CNKI）, Wanfang Digital Journal Full-text Database, and database for Chinese Technical Periodicals（VIP） till Nov. 2014 were searched for the cohort studies and case-control studies in evaluating the effect of metformin on colorectal cancer. A meta-analysis was performed using Rev Man5.2 software. The quality assessment of included studies was evaluated according to the Newcastle-Ottawa scale（NOS）. Results A total of 11 original articles met the inclusion criteria, 8 of them were articles with cohort studies including 12 subgroup studies with 447 234 subjects, and the other 3 case-control studies with 24 032 subjects. Metaanalysis of cohort studies showed that metformin therapy reduced the risk of pathogenesis of colorectal cancer by 30% in type 2 diabetes patients compared with those with other oral glucose-lowering drugs（RR=0.70, 95%CI： 0.58-0.85, P=0.0002）. The results from the case-control studies showed that metformin therapy may be associated with a reduced risk of colorectal cancer in patients with type 2 diabetes（OR=0.78, 95%CI： 0.71-0.86, P〈0.00001）. Conclusion Metformin therapy can lower the risk of pathogenesis of colorectal cancer in patients with type 2 diabetes.

关 键 词：结直肠肿瘤 二甲双胍 糖尿病 2型 META分析 

分 类 号：R587.1[医药卫生—内分泌] R735.34[医药卫生—内科学]