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BMJ:胰高血糖素样肽-1类似物不会增加乳腺癌风险

2016-10-21 MedSci MedSci原创

来自加拿大的研究人员开展了一项基于人群的队列研究。

来自加拿大的研究人员开展了一项基于人群的队列研究,该研究旨在确定与使用二肽基肽酶-4(DPP-4)抑制剂相比,使用胰高血糖素样肽-1(GLP-1)类似物是否增加2型糖尿病患者发生乳腺癌的风险。

该研究的数据来源于英国的临床实践研究数据库,共包括44984名40岁以上的女性,这些女性在2007年1月1日至2015年3月31日期间开始使用降糖药物治疗,随访至2016年3月31日。

为了达到延迟的目的,与使用DPP-4抑制剂相比,GLP-1类似物的随时间变化的使用延迟一年。研究人员使用时间依赖性Cox比例风险模型来估计与使用GLP-1类似物相关的乳腺癌事件的95%置信区间的调整风险比,通过累积使用持续时间进行评估,从开始使用的时间计算。

平均随访时间为3.5年(标准偏差2.2),共有549例乳腺癌事件发生(粗发病率为每1000人年3.5例(95%置信区间3.3至3.8))。总体而言,与使用DPP-4抑制剂相比,使用GLP-1类似物与乳腺癌的风险增加无关(发病率4.4 vs 3.4例/1000人年;风险比1.40(95%置信区间0.91至2.16))。危险比随着使用时间的延长而逐渐增加,在使用GLP-1的二至三年之间达到峰值(2.66(95%置信区间1.32至5.38)),并且在使用三年以上后接近零(0.98(0.24至4.03))。从开始使用GLP-1类似物以来,研究人员就观察到了类似的模式。

在这项基于人群的队列研究中,使用GLP-1类似物并不会增加乳腺癌的总体风险。尽管不可能排除肿瘤启动子效应,但观察到的持续时间-反应关联可能是GLP-1类似物使用者中乳腺癌检测短暂增加的结果。

原始出处:

Blánaid M Hicks,Hui Yin,Oriana H Y Yu,et al.Glucagon-like peptide-1 analogues and risk of breast cancer in women with type 2 diabetes,BMJ,2016.10.21


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    2017-08-21 gaoxiaoe
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    2017-03-26 sjq027
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    2016-10-22 hbwxf
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Heart:治疗2型糖尿病选择胰岛素还是胰高血糖素样肽-1类似物?

研究表明在肥胖的2型糖尿病患者中,通过口服胰高血糖素样肽-1类似物强化双药治疗与在日常临床实践中降低主要不良心脏事件相关,相对于胰岛素,胰高血糖素样肽-1类似物更应该成为双药治疗后的第三个降血药物。

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