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PPAR-γ agonist pioglitazone and the risks of malignancy among type2 diabetes mellitus patients

Lai-Chu See1,2, Chao-Yi Wu3,4, Chung-Ying Tsai5

  • 1Department of Public Health, College of Medicine, Chang Gung University, Taoyuan, Taiwan.

Acta Diabetologica
|September 30, 2024
PubMed
Abstract

Insights

Pioglitazone, a PPAR-gamma agonist, may reduce the risk of overall malignancies, especially breast and prostate cancers. However, it might increase the risk of pancreatic cancer.

Area of Science:

  • Oncology
  • Pharmacology
  • Epidemiology

Background:

  • Peroxisome proliferator-activated receptor gamma (PPAR-gamma) agonists show potential in inhibiting cancer progression.
  • Pioglitazone is the only available PPAR-gamma agonist, but previous studies linked it to bladder cancer risks.

Purpose of the Study:

  • To investigate the association between pioglitazone use and the risk of developing various malignancies.
  • To assess the influence of pioglitazone on tumor development in patients with type 2 diabetes.

Main Methods:

  • A nested case-control study utilized Taiwan's National Health Insurance Research Database.
  • Identified patients with type 2 diabetes initiating metformin treatment between 2000-2014.
  • Analyzed pioglitazone exposure preceding malignancy diagnosis or a matched date.

Main Results:

  • Included 47,931 cancer patients and 47,931 matched non-cancer controls.
  • Lower pioglitazone prescription rates were observed in the cancer group for overall malignancies.
  • Pioglitazone use was more frequent in non-cancer patients for breast and prostate cancers, but more common in cancer patients for pancreatic cancer.

Conclusions:

  • PPAR-gamma agonists, like pioglitazone, may be associated with a reduced risk of overall malignancies, particularly breast and prostate cancers.
  • Conversely, pioglitazone use might be linked to an increased risk of pancreatic cancer.
Keywords:
Breast cancerMalignanciesPPAR-gammaPancreatic cancerPioglitazoneType2 diabetes

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