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Diabetes Obes Metab：非胰岛素降糖药——肠促胰岛素，是否增加胰腺癌风险？

2016-01-04 Seven L 译 MedSci原创

肠促胰岛素糖尿病胰腺癌
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肠促胰岛素属于非胰岛素降糖药物（NIAD），是治疗2型糖尿病（T2DM）的新药物。虽然已有研究证明肠促胰岛素的有效性，但该药物与胰腺癌具有一定联系。目前关于肠促胰岛素和胰腺癌间关系的数据很少，因此研究者进行了一项研究调查两者间联系。该项基于人群的回顾性队列研究使用了CPRD 2007-2012年的数据，纳入182,428名使用NIAD治疗的18岁以上患者，并匹配一名非糖尿病患者为对照组。使用多因素

肠促胰岛素属于非胰岛素类降糖药物（NIAD），是治疗2型糖尿病（T2DM）的新药。虽然已有研究证明肠促胰岛素的有效性，但该药物与胰腺癌具有一定联系。目前关于肠促胰岛素和胰腺癌间关系的数据很少，因此研究者进行了一项研究调查两者间联系。

该项基于人群的回顾性队列研究使用了CPRD 2007-2012年的数据，纳入182,428名使用NIAD治疗的18岁以上患者，并匹配一名非糖尿病患者为对照组。使用多因素Cox风险比例模型和诊断新使用者设计(N=28.370)的分析评估肠促胰岛素者中胰腺癌风险。

研究数据显示，对肠促胰岛素使用者平均随访时间4.1年，当前使用NIAD胰腺癌风险增加4倍 (HR = 4.28, 95% CI 3.49-5.24)。与对照组相比当前使用肠促胰岛素，胰腺癌风险几乎翻倍。与糖尿病控制组相比，肠促胰岛素不会增加胰腺癌风险 (HR = 1.36, 95% CI 0.94-1.96)；但针对新使用者设计的分析显示两者间具有一定联系。两组队列均提示新近开始使用肠促胰岛素（不超过7张处方）患者，其胰腺癌风险翻倍，但长时间使用后风险又会下降到极限水平。

对2型糖尿病严重程度进行校正后，研究者并没有发现肠促胰岛素与胰腺癌间的联系。新近开始使用肠促胰岛素增加胰腺癌风险的结果，可能是因为偏倚的存在或其他未知的失真引起的。疾病严重程度参差不齐，药物使用持续时间数据缺乏等均不支持肠促胰岛素和胰腺癌间的因果关系。

原始出处：

Knapen LM, van Dalem J,et a.Use of Incretin Agents and Risk of Pancreatic Cancer: A Population-Based Cohort Study.Diabetes Obes Metab. 2015 Nov 5.

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    2016-05-29 ms9608593228839890

    #DIA#

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    #胰岛#

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    2016-01-19 ms5439512287675881

    #BET#

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topicList=[TopicDto(id=5917, encryptionId=c097591ed5, topicName=Diabetes)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0045169, createdName=木头人513, createdTime=Tue Apr 12 17:23:00 CST 2016, time=2016-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1887500, encodeId=16e0188e5007a, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8f4110, createdName=guojianrong, createdTime=Tue Jan 12 00:23:00 CST 2016, time=2016-01-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1895874, encodeId=78fd18958e4e6, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Fri Jun 03 15:23:00 CST 2016, time=2016-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2061504, encodeId=01f82061504e6, content=<a href='/topic/show?id=e6e1e15509f' target=_blank style='color:#2F92EE;'>#癌风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71550, encryptionId=e6e1e15509f, topicName=癌风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d58a435, createdName=sjq027, createdTime=Sat Oct 08 09:23:00 CST 2016, time=2016-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=80824, encodeId=398f80824ea, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Fri Apr 22 17:03:00 CST 2016, time=2016-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=80823, encodeId=0b0180823da, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Fri Apr 22 17:03:00 CST 2016, time=2016-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=80822, encodeId=6b148082247, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Fri Apr 22 17:03:00 CST 2016, time=2016-04-22, status=1, ipAttribution=)]
    2016-04-12 木头人513

    #Diabetes#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1637247, encodeId=cc6e163e247ae, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Sun May 29 20:23:00 CST 2016, time=2016-05-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1749583, encodeId=8d1a1e4958307, content=<a href='/topic/show?id=be7c8385345' target=_blank style='color:#2F92EE;'>#胰岛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83853, encryptionId=be7c8385345, topicName=胰岛)], attachment=null, authenticateStatus=null, createdAvatar=null, 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objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Fri Jun 03 15:23:00 CST 2016, time=2016-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2061504, encodeId=01f82061504e6, content=<a href='/topic/show?id=e6e1e15509f' target=_blank style='color:#2F92EE;'>#癌风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71550, encryptionId=e6e1e15509f, topicName=癌风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d58a435, createdName=sjq027, createdTime=Sat Oct 08 09:23:00 CST 2016, time=2016-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=80824, encodeId=398f80824ea, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Fri Apr 22 17:03:00 CST 2016, time=2016-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=80823, encodeId=0b0180823da, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Fri Apr 22 17:03:00 CST 2016, time=2016-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=80822, encodeId=6b148082247, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Fri Apr 22 17:03:00 CST 2016, time=2016-04-22, status=1, ipAttribution=)]
    2016-01-12 guojianrong

    #Meta#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1637247, encodeId=cc6e163e247ae, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Sun May 29 20:23:00 CST 2016, time=2016-05-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1749583, encodeId=8d1a1e4958307, content=<a href='/topic/show?id=be7c8385345' target=_blank style='color:#2F92EE;'>#胰岛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83853, encryptionId=be7c8385345, topicName=胰岛)], attachment=null, authenticateStatus=null, createdAvatar=null, 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objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Fri Jun 03 15:23:00 CST 2016, time=2016-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2061504, encodeId=01f82061504e6, content=<a href='/topic/show?id=e6e1e15509f' target=_blank style='color:#2F92EE;'>#癌风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71550, encryptionId=e6e1e15509f, topicName=癌风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d58a435, createdName=sjq027, createdTime=Sat Oct 08 09:23:00 CST 2016, time=2016-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=80824, encodeId=398f80824ea, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Fri Apr 22 17:03:00 CST 2016, time=2016-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=80823, encodeId=0b0180823da, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Fri Apr 22 17:03:00 CST 2016, time=2016-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=80822, encodeId=6b148082247, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Fri Apr 22 17:03:00 CST 2016, time=2016-04-22, status=1, ipAttribution=)]
    2016-06-03 一闲

    #MET#

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1637247, encodeId=cc6e163e247ae, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Sun May 29 20:23:00 CST 2016, time=2016-05-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1749583, encodeId=8d1a1e4958307, content=<a href='/topic/show?id=be7c8385345' target=_blank style='color:#2F92EE;'>#胰岛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83853, encryptionId=be7c8385345, topicName=胰岛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a7a536274692, createdName=baoya, createdTime=Sun Aug 14 12:23:00 CST 2016, time=2016-08-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1759625, encodeId=beda1e596250d, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Tue Jan 19 18:23:00 CST 2016, time=2016-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1901341, encodeId=22d2190134121, content=<a href='/topic/show?id=c097591ed5' target=_blank style='color:#2F92EE;'>#Diabetes#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, 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objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Fri Jun 03 15:23:00 CST 2016, time=2016-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2061504, encodeId=01f82061504e6, content=<a href='/topic/show?id=e6e1e15509f' target=_blank style='color:#2F92EE;'>#癌风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71550, encryptionId=e6e1e15509f, topicName=癌风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d58a435, createdName=sjq027, createdTime=Sat Oct 08 09:23:00 CST 2016, time=2016-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=80824, encodeId=398f80824ea, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Fri Apr 22 17:03:00 CST 2016, time=2016-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=80823, encodeId=0b0180823da, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Fri Apr 22 17:03:00 CST 2016, time=2016-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=80822, encodeId=6b148082247, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Fri Apr 22 17:03:00 CST 2016, time=2016-04-22, status=1, ipAttribution=)]
    2016-10-08 sjq027

    #癌风险#

    0

  8. 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    2016-04-22 忠诚向上

    值得学习

    0

  9. 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    2016-04-22 忠诚向上

    值得学习

    0

  10. 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    2016-04-22 忠诚向上

    值得学习

    0

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