Metformin Is Associated With Slightly Reduced Risk of Colorectal Cancer and Moderate Survival Benefits in Diabetes Mellitus: A Meta-Analysis

被引:59
作者
He, Xing-kang [1 ,2 ]
Su, Ting-ting [1 ,2 ]
Si, Jian-min [1 ,2 ]
Sun, Lei-min [1 ,2 ]
机构
[1] Zhejiang Univ, Sch Med, Sir Run Run Shaw Hosp, Dept Gastroenterol, Hangzhou 310016, Zhejiang, Peoples R China
[2] Zhejiang Univ, IGZJU, Inst Gastroenterol, Hangzhou 310003, Zhejiang, Peoples R China
基金
中国国家自然科学基金;
关键词
INCIDENT CANCER; IN-VIVO; COHORT; MORTALITY; IMPACT; HETEROGENEITY; PREVENTION; OUTCOMES; THERAPY; PEOPLE;
D O I
10.1097/MD.0000000000002749
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
To systematically assess the effect of metformin on colorectal cancer (CRC) risk and mortality in type 2 diabetes mellitus (T2DM) patients.We conducted a systematic search of PubMed, Web of Science, and the Cochrane Library databases for relevant articles before August 2015. Two investigators identified and extracted data independently. We adopted adjusted estimates to calculate summary estimates with 95% confidence interval (CI) using either a fixed-effects or a random-effects model. Subgroup and sensitivity analyses were conducted to evaluate the robustness of the pooled results. The risk of publication bias was assessed by examining funnel plot asymmetry as well as Begg test and Egger test.Fifteen studies on CRC incidence and 6 studies on CRC survival were finally included in our meta-analysis. The pooled odds ratio (OR) of observational studies illustrated that a slight 10% reduction of CRC incidence was associated with metformin use (OR=0.90, 95% CI: 0.85-0.96). Furthermore, the pooled hazard ratio (HR) revealed an improved survival outcome for metformin users in CRC patients compared to nonusers (HR=0.68, 95% CI: 0.58-081). There was no publication bias across studies.Our meta-analysis demonstrated that metformin therapy could slightly reduce CRC incidence and moderately improve the survival outcomes in patients with T2DM. More prospective studies are warranted to certify this protective association.
引用
收藏
页数:10
相关论文
共 56 条
[1]   Metformin blocks the stimulative effect of a high-energy diet on colon carcinoma growth in vivo and is associated with reduced expression of fatty acid synthase [J].
Algire, Carolyn ;
Amrein, Lilian ;
Zakikhani, Mahvash ;
Panasci, Lawrence ;
Pollak, Michael .
ENDOCRINE-RELATED CANCER, 2010, 17 (02) :351-360
[2]   The antidiabetic drug metformin exerts an antitumoral effect in vitro and in vivo through a decrease of cyclin D1 level [J].
Ben Sahra, I. ;
Laurent, K. ;
Loubat, A. ;
Giorgetti-Peraldi, S. ;
Colosetti, P. ;
Auberger, P. ;
Tanti, J. F. ;
Le Marchand-Brustel, Y. ;
Bost, F. .
ONCOGENE, 2008, 27 (25) :3576-3586
[3]   Use of Metformin Is Not Associated with a Decreased Risk of Colorectal Cancer: A Case-Control Analysis [J].
Bodmer, Michael ;
Becker, Claudia ;
Meier, Christian ;
Jick, Susan S. ;
Meier, Christoph R. .
CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION, 2012, 21 (02) :280-286
[4]   Long-term use of metformin and colorectal cancer risk in type II diabetics: a population-based case-control study [J].
Cardel, Majken ;
Jensen, Sara M. ;
Pottegard, Anton ;
Jorgensen, Trine L. ;
Hallas, Jesper .
CANCER MEDICINE, 2014, 3 (05) :1458-1465
[5]   Diabetes, metformin use, and colorectal cancer survival in postmenopausal women [J].
Cossor, Furha Iram ;
Adams-Campbell, Lucile L. ;
Chlebowski, Rowan T. ;
Gunter, Marc J. ;
Johnson, Karen ;
Martell, Robert E. ;
McTiernan, Anne ;
Simon, Michael S. ;
Rohan, Thomas ;
Wallace, Robert B. ;
Paulus, Jessica K. .
CANCER EPIDEMIOLOGY, 2013, 37 (05) :742-749
[6]   The influence of glucose-lowering therapies on cancer risk in type 2 diabetes [J].
Currie, C. J. ;
Poole, C. D. ;
Gale, E. A. M. .
DIABETOLOGIA, 2009, 52 (09) :1766-1777
[7]   Mortality After Incident Cancer in People With and Without Type 2 Diabetes Impact of metformin on survival [J].
Currie, Craig J. ;
Poole, Chris D. ;
Jenkins-Jones, Sara ;
Gale, Edwin A. M. ;
Johnson, Jeffrey A. ;
Morgan, Christopher Ll. .
DIABETES CARE, 2012, 35 (02) :299-304
[8]   Metformin and Cancer Risk in Diabetic Patients: A Systematic Review and Meta-analysis [J].
DeCensi, Andrea ;
Puntoni, Matteo ;
Goodwin, Pamela ;
Cazzaniga, Massimiliano ;
Gennari, Alessandra ;
Bonanni, Bernardo ;
Gandini, Sara .
CANCER PREVENTION RESEARCH, 2010, 3 (11) :1451-1461
[9]   Metformin: Multi-faceted protection against cancer [J].
Del Barco, Sonia ;
Vazquez-Martin, Alejandro ;
Cufi, Silvia ;
Oliveras-Ferraros, Cristina ;
Bosch-Barrera, Joaquim ;
Joven, Jorge ;
Martin-Castillo, Begona ;
Menendez, Javier A. .
ONCOTARGET, 2011, 2 (12) :896-917
[10]   METAANALYSIS IN CLINICAL-TRIALS [J].
DERSIMONIAN, R ;
LAIRD, N .
CONTROLLED CLINICAL TRIALS, 1986, 7 (03) :177-188