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Published on: April 23, 2018
A population-based cohort study in Taiwan--use of insulin sensitizers can decrease cancer risk in diabetic patients?
1Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine; Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung.
Summary
Diabetic patients face higher cancer risks, particularly for colorectal and pancreatic cancers. Thiazolidinediones (TZDs) may reduce liver cancer risk in these individuals.
Area of Science:
- Endocrinology
- Oncology
- Pharmacoepidemiology
Background:
- Diabetes mellitus is a growing global health concern.
- Patients with diabetes exhibit an increased risk for various cancers.
- Insulin sensitizers, specifically thiazolidinediones (TZDs), are commonly used antidiabetic medications.
Purpose of the Study:
- To investigate the association between TZD use and cancer risk in Taiwanese diabetic patients.
- To compare cancer risk between TZD users, non-TZD users, and non-diabetic individuals.
Main Methods:
- Retrospective cohort study using Taiwan's National Health Insurance Research Database (NHIRD).
- Identified 22,910 diabetic patients and 91,636 matched non-diabetic controls (2001-2009).
- Categorized diabetic patients into TZD (4,159) and non-TZD (18,752) groups.
Main Results:
- Non-TZD diabetic patients showed an increased cancer risk (aHR: 1.20, 95% CI: 1.11-1.30) compared to non-diabetics.
- TZD users had a hazard ratio of 1.18 (95% CI: 0.98-1.42) for overall cancer risk.
- Both diabetic groups had elevated risks for colorectal and pancreatic cancers; non-TZD users had higher liver cancer risk.
Conclusions:
- Diabetic patients have a significantly elevated risk of developing cancer, particularly colorectal and pancreatic types.
- Thiazolidinedione (TZD) use may be associated with a reduced risk of liver cancer in diabetic patients.
- Further large-scale studies are needed to confirm these findings and elucidate mechanisms.
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