Farid Najafi, Fatemeh Rajati, Diana Sarokhani, Maryam Bavandpour, Mehdi Moradinazar
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引用次数: 0
Abstract
Background: Considering that metformin is widely used in the treatment of diabetes, and its protective role against various malignancies, the strength and validity of the available evidence from related systematic reviews and meta-analysis were evaluated.
Methods: Scopus, PubMed, Embase, Cochrane, Web of science databases, and Google Scholar and manual screening of retrieved references were systematically searched from their inception dates to 24 March 2020 by extracting the effect size (Odds ratios (OR) and relative risk (RR) in each study. To present the forest plot of effect of metformin on each cancer, Stata version 14.2 was used.
Results: This study included 36 meta-analysis studies and 620 original research studies (26 randomized control trials studies and 594 observational studies (cohort, case-control)) covering 15 different cancers. Overall, metformin medication prevented different cancers, including ovarian cancer (OR = 0.76, 95% CI: 0.62,0.93), cervical cancer (OR = 0.60, 95% CI: 0.43, 0.83), endometrial cancer (OR = 1.05, 95% CI: 0.82,1.35), liver cancer (OR = 0.59, 95% CI: 0.47,0.74), pancreatic cancer (OR = 0.59, 95%CI 0.50,0.69), head and neck cancer (OR = 0.71, 95% CI: 0.61,0.83), stomach cancer (OR = 0.72, 95% CI: 0.26,1.99), colorectal cancer (OR = 0.73, 95% CI: 0.59,0.91), colorectal adenoma cancer (OR = 0.75, 95% CI: 0.65,0.86), colon cancer (OR = 0.79, 95% CI: 0.69,0.91), esophagus cancer (OR = 0.90, 95% CI: 0.83,0.98), lung cancer (OR = 0.92, CI95%:0.85,0.99), breast cancer (OR = 0.93, 95% CI: 0.84,1.02), prostate cancer (OR = 0.94, 95% CI: 0.85-1.04), and bladder cancer (OR = 0.94 95% CI: 0.64,1.38).
Conclusions: Treatment with metformin can significantly decrease the chance of all cancers with larger preventive effect on hepatocellular carcinoma and smaller preventive effect on lung and breast cancers.
背景:考虑到二甲双胍在糖尿病治疗中的广泛应用及其对各种恶性肿瘤的保护作用,对相关系统综述和荟萃分析中的可用证据的强度和有效性进行了评估。方法:从Scopus、PubMed、Embase、Cochrane、Web of science数据库和Google Scholar开始到2020年3月24日,通过提取每项研究的效应大小(比值比(OR)和相对风险(RR)),对检索到的参考文献进行系统搜索和手动筛选。为了呈现二甲双胍对每种癌症影响的森林图,使用了Stata版本14.2。结果:本研究包括36项荟萃分析研究和620项原始研究(26项随机对照试验研究和594项观察性研究(队列、病例对照)),涵盖15种不同的癌症。总体而言,二甲双胍药物预防了不同的癌症,包括卵巢癌症(OR=0.76,95%CI:0.62,0.93)、癌症宫颈癌(OR=0.60,95%CI:0.43,0.83)、癌症子宫内膜癌(OR=1.05,95%CI:0.82,1.35)、癌症肝癌(OR=0.59,95%CI:0.47,0.74)、癌症胰腺癌(OR:0.59,95%CI0.50,0.69)、癌症头颈部癌(OR=7.71,95%CI:0.61,0.83,胃癌症(OR=0.72,95%CI:0.26,1.99,95%置信区间:0.85-1.04),结论:二甲双胍治疗可显著降低所有肝癌的发病率,对肝癌的预防作用较大,对肺癌和乳腺癌的预防作用较小。
期刊介绍:
International Journal of Preventive Medicine, a publication of Isfahan University of Medical Sciences, is a peer-reviewed online journal with Continuous print on demand compilation of issues published. The journal’s full text is available online at http://www.ijpvmjournal.net. The journal allows free access (Open Access) to its contents and permits authors to self-archive final accepted version of the articles on any OAI-compliant institutional / subject-based repository. The journal will cover technical and clinical studies related to health, ethical and social issues in field of Preventive Medicine. Articles with clinical interest and implications will be given preference.