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Diabetes Care:基于肠促胰岛素治疗和胰腺癌的短期风险!

2017-11-17 xing.T MedSci原创

由此可见,采用肠促胰岛素治疗与胰腺癌风险增加有关。这种增加的原因可能是引发或加重糖尿病的隐匿性胰腺癌的结果,评估肠促胰岛素药物长期使用相关的胰腺癌风险需要进行进一步研究。

基于肠促胰岛素的治疗可能增加胰腺癌的风险已经引起关注。近日,糖尿病领域权威杂志Diabetes Care上发表了研究文章,研究人员旨在评估服用肠促胰岛素药物的糖尿病患者患胰腺癌的风险。
 
随着比利时、伦巴第地区和意大利的公共健康保险数据库投入使用,研究人员组建了两个回顾性队列,从2008年7月1日到2013年12月31日期间在比利时和2008年1月1日到2012年12月31日在伦巴第地区纳入了第一次将肠促胰岛素药物或其他非胰岛素降糖药(NIAD)写进处方的受试者。研究人员采用包含时间相关变量的多变量校正Cox模型评估胰腺癌的风险。研究人员使用固定效应荟萃分析对从比利时和意大利得到的调整后风险比(aHRS)进行合并。

该研究的队列包含了525733例采用NIADs治疗的糖尿病患者和33292例采用肠促胰岛素治疗的糖尿病患者。两组患者的结果相似,在服用肠促胰岛素和NIADs治疗的患者中分别有85和1589例受试者发生胰腺癌,其中相比于NIAD治疗,肠促胰岛素治疗aHR为2.14(95%可信区间为1.71-2.67)。6个月内服用药物滞后暴露的aHR为1.69(1.24-2.32)。aHR从首次服用肠促胰岛素后头3个月的3.35(2.32-4.84)下降到3-5.9月的2.12(1.22-3.66),再到6-11.9月的1.95(1.20-3.16)以及12个月的1.69(1.12-2.55)。在那些服用NIAD的受试者中,胰腺癌多发生在开始服药后的前一年内。在随后使用胰岛素的患者中患胰腺癌的风险为6.89(6.05-7.85)。

由此可见,采用肠促胰岛素治疗与胰腺癌风险增加有关。这种增加的原因可能是引发或加重糖尿病的隐匿性胰腺癌的结果,评估肠促胰岛素药物长期使用相关的胰腺癌风险需要进行进一步研究。
 
原始出处:
 
Mathieu Boniol,et al. Incretin-Based Therapies and the Short-Term Risk of Pancreatic Cancer: Results From Two Retrospective Cohort Studies.Diabetes Care 2017. https://doi.org/10.2337/dc17-0280
 
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    2018-10-14 baoya
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    2017-11-26 lou.minghong

    要权衡利弊再使用

    0

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    2017-11-17 圣艮山

    学习了不少事情!

    0

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