钠-葡萄糖转运蛋白2抑制剂与2型糖尿病患者恶性肿瘤发生风险的Meta分析

SGLT2 inhibitors and cancer risk in patients with type 2 diabetes mellitus:a Meta-analysis

目的:系统评价钠-葡萄糖转运蛋白2(sodium-glucose transporter 2 inhibitors,SGLT2)抑制剂的使用与2型糖尿病患者肿瘤发病的关系,为明确二者之间关系提供循证医学依据。方法:以"钠-葡萄糖转运蛋白2(SGLT2)抑制剂、达格列净(dapagliflozin)、坎格列净(canagliflozin)、恩格列净(empagliflozin)、2型糖尿病、肿瘤"等为关键词,通过PubMed、Embase、Web of Science、Cochrane Library及万方、中国知网(CNKI)、维普中文期刊(VIP)等数据库检索2021年2月以前发表的中英文文献,确定符合条件的随机对照试验(randomized controlled trials,RCTs)。运用RevMan 5.3和Stata 15.0软件进行统计学处理。结果:最终纳入17篇文献,共35299例患者,其中1072例2型糖尿病患者罹患恶性肿瘤。Meta分析结果表明,与对照组相比,SGLT2抑制剂与总体肿瘤风险增加无显著相关性(RR=0.98,95%CI:0.96~1.36)。不同SGLT2抑制剂对肿瘤发生的风险无显著相关性(RR=0.92,95%CI:0.81~1.04)。结论:目前来自短期随机对照试验的证据并未表明使用SGLT2抑制剂的2型糖尿病患者有增加发生恶性肿瘤的风险。

OBJECTIVE To provide evidence-based medical rationales for clarifying the relationship between using SGLT2 inhibitors and the incidence of cancer in patients with type 2 diabetes and systematically evaluate the relationship through Meta-analysis.METHODS Two investigators searched the databases of PubMed,Embase,Web of Science,Cochrane Library,WanFang data,CNKI and VIP for sodium glucose transporter 2 inhibitors(SGLT2),dapagliflozin,canagliflozin,empagliflozin,type 2 diabetes mellitus and tumor.The Chinese and English literatures published prior to February 2021 were searched for eligible randomized controlled trials(RCTs).And Revman 5.3 and Stata 15.0 software programs were utilized for statistical analysis.RESULTS A total of 17 studies involving 35299 patients were included.Among them,1072 type 2 diabetics suffered from malignant tumor.Meta-analysis indicated that,as compared with control group,SGLT2 inhibitors had no significant correlation with overall tumor risk(RR=0.98,95%CI:0.96-1.36).No significant correlation existed between different SGLT2 inhibitors and the risk of tumorigenesis(RR=0.92,95%CI:0.81-1.04).CONCLUSION Current evidence of short-term RCTs fails to show a markedly elevated risk of overall cancer among individuals with type 2 diabetes using SGLT2 inhibitors.