二甲双胍降低2型糖尿病患者胃癌发生率的Meta分析

Meta-analysis of metformin reducing the gastric cancer risk of patients with type 2 diabetes

目的系统评价二甲双胍降低2型糖尿病患者胃癌发生率的有效性。方法检索Cochrane Library、EMbase、PubMed数据库,收集2010年1月至2016年12月关于二甲双胍治疗2型糖尿病患者胃癌发生率的临床试验,按照纳入和排除标准筛选文献,提取相关数据,应用STATA 12.0软件进行Meta分析。结果共纳入5篇文献研究,涉及442 254例2型糖尿病患者。Meta分析结果显示,二甲双胍治疗2型糖尿病患者组胃癌发生率低于非二甲双胍治疗组:OR=0.512,95%CI(0.438,0.599),P<0.001;与胰岛素降糖治疗组比较:OR=0.447,95%CI(0.311,0.644),P<0.001;与磺脲类降糖治疗组比较:OR=0.449,95%CI(0.347,0.580),P<0.001;与噻唑烷二酮类药物罗格列酮治疗组比较:OR=0.300,95%CI(0.166,0.541),P<0.001。结论与其他降糖药物相比,二甲双胍治疗2型糖尿病患者具有较低的胃癌发生率。

Objective To systematically estimate the efficacy of mefformin in reducing the risk of gastric cancer of patients with type 2 diabetes. Methods Clinical trials about mefformin treatment for type 2 diabetes pub- lished from January 2010 to November 2016 were collected in the database of Cochrane library ,EMbase and PubMed. The studies were screened according to the inclusion and exclusion criteria, and the data was extracted. Meta-analysis was performed to evaluate the data by using STATA 12. 0 software. Results Totally 5 articles （ n = 442 254 ） were in- eluded in the study. The incidence of gastric cancer in mefformin treatment group was lower than that of non-mefformin groups [ OR =0. 512,95% CI （0. 438,0. 599） ,P 〈0. 001 ] ,insulin group [ OR =0. 447,95% CI （0. 311,0. 644） ,P 〈 0. 001 ], sulfonylurea group E OR = 0. 449,95 % CI （0. 347,0. 580 ）, P 〈 0. 001 ] and rosiglitazone group [ OR = O. 300, 95 % CI （0. 166,0. 541 ）, P 〈 0. 001 ]. Conclusion Mefformin has lower incidence of gastric cancer than the other hy- poglycemic agents in the treatment of patients with type 2 diabetes.