A study based on propensity score matching to explore the association between glucose-lowering drug use and pancreatic cancer
10.3781/j.issn.1000-7431.2024.2407-0444
- VernacularTitle:临床研究基于倾向性评分匹配探究降糖药物使用与胰腺癌发生的相关性研究
- Author:
Mingnan PU
1
;
Chunyan PENG
;
Shu ZHANG
;
Ying LÜ
Author Information
1. 南京中医药大学鼓楼临床医学院消化内科,江苏 南京 210008
- Publication Type:Journal Article
- Keywords:
Pancreatic cancer;
Type 2 diabetes mellitus;
Glucose-lowering drugs;
Relevance study;
Propensity Score Match
- From:
Tumor
2024;44(12):1170-1179
- CountryChina
- Language:Chinese
-
Abstract:
Objective:This study aimed to investigate the correlation between the use of glucose-lowering drugs and the risk of pancreatic cancer through propensity score matching(PSM),which provides a scientific basis for clinical decision-making.Methods:This study retrospectively analyzed the clinical data of patients diagnosed with type 2 diabetes mellitus(T2DM)and treated with glucose-lowering drugs in Nanjing Drum Tower Hospital between 2000 and 2023.The patients were divided into two groups:those with T2DM alone and those with T2DM combined with pancreatic cancer.PSM was employed to align the baseline characteristics of patients across groups,minimizing the impact of confounding factors.According to the use of glucose-lowering drugs,the correlation between the use of various types of glucose-lowering drugs and the occurrence of pancreatic cancer was explored by logistic regression analysis,and the drug influencing factors that might potentially affect the occurrence of pancreatic cancer were screened out.Additionally,the relationship between the use of glucose-lowering medications,both as monotherapy and in combination,and the occurrence of pancreatic cancer was further analyzed.Results:The logistic regression analyses showed that previous use of sulfonylureas was significantly associated with pancreatic cancer in patients with T2DM,and previous use of dipeptidyl peptidase-4(DPP-4)inhibitors was weakly associated with pancreatic cancer,and sulfonylureas[odds ratio(OR)=0.631,95%CI:0.415-0.961,P=0.032]and dipeptidyl peptidase-4(DPP-4)inhibitors(OR=0.639,95%CI:0.388-1.052,P=0.078)may be associated with a reduced risk of pancreatic cancer in T2DM patients.Other drugs,including insulin,metformin,α-glucosidase inhibitors,and sodium-glucose transporter-2(SGLT-2)inhibitors,were not significantly associated with pancreatic cancer development.In a further analysis of glucose-lowering treatment regimens,it was shown that metformin in combination with other oral glucose-lowering agents was associated with pancreatic cancer[adjustment OR(aOR)=0.463,95%CI:0.224-0.959,P=0.038]and may be a protective factor for pancreatic carcinogenesis.Conclusion:The use of sulfonylureas and DPP-4 inhibitors in T2DM patients is related to the reduction of pancreatic cancer,and compared with the use of drugs alone,the use of drugs combined with oral hypoglycemic drugs can further reduce the incidence of pancreatic cancer.
