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【medical-news】胰岛素增敏剂噻唑烷酮类药可能增
Higher Cancer Prevalence Seen Among Diabetics Taking Thiazolidinediones
By Will Boggs, MD
NEW YORK (Reuters Health) Jul 18 - Patients with diabetes, especially women, who take thiazolidinediones (TZDs) may have an increased risk of developing cancer, according to a report in the June 21st publication of BMC Medicine.
"There is more to these drugs than first meets the eye," Dr. Maria E. Ramos-Nino from the University of Vermont, Burlington, told Reuters Health. "The long-term consequences and benefits are not understood."
Dr. Ramos-Nino and colleagues investigated the association of TZDs and cancer prevalence among nearly 9000 diabetic patients participating in the Vermont Diabetes Information System. A randomly selected sample of 1003 of these participants were interviewed about personal and clinical parameters, including any history of malignancy.
The investigators found that the use of any TZD was associated with a 59% increased risk of cancer in a logistic regression model corrected for use of sulfonylureas and biguanides, age, HbA1c, BMI, smoking, comorbidity, and other medications.
There was a significant association with rosiglitazone use with an odds ratio of 1.89 (p = 0.02) for malignancy, but not with pioglitazone use (OR = 1.09, p = 0.76).
"We are not aware of a convincing explanation or previous results to support the finding in this study of an association with cancer for rosiglitazone, but not for pioglitazone," the researchers write. "As both are thought to activate PPAR-gamma with similar potency, this finding suggests another mechanism for the association."
Women taking TZDs were more than twice as likely to have cancer as women not taking TZDs (OR = 2.07, p = 0.01), the researchers note, but the association was not significant in men (OR = 1.20, p= 0.63).
The use of sulfonylurea by women was associated with a 51% lower risk of cancer, the report indicates.
"The gender-dependent observation is difficult to explain," the team notes. "We do not know which specific tumors are increased in the TZD users in this population."
The authors acknowledge that the study has several limitations, including its cross-sectional design, lack of confirmation of cancer and absence of information on the temporal relation between TZD use and cancer.
"Our data do not provide strong evidence to change practice at this time," Dr. Ramos-Nino said. "They are disturbing, to be sure, but require further investigation before clinical decisions should be changed." 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 请战友纠错！
BMC Medicine 2007;5.
BMC医学杂志2007;5.
Higher Cancer Prevalence Seen Among Diabetics Taking Thiazolidinediones
胰岛素增敏剂噻唑烷酮类药可能增加女性癌症发病率
By Will Boggs, MD
NEW YORK (Reuters Health) Jul 18 - Patients with diabetes, especially women, who take thiazolidinediones (TZDs) may have an increased risk of developing cancer, according to a report in the June 21st publication of BMC Medicine.
纽约（路透社 健康新闻）7月18日---据6月21日发表在BMC医学杂志上的一项报告称，服用噻唑烷二酮（TZD）的糖尿病患者，特别是女性，患癌症的风险可能会增加。
"There is more to these drugs than first meets the eye," Dr. Maria E. Ramos-Nino from the University of Vermont, Burlington, told Reuters Health. "The long-term consequences and benefits are not understood."
伯明翰, 佛蒙特州立大学的Maria E. Ramos-Nino博士告诉路透社健康新闻记者，“这类药物的风险并不止于此”。但其“长期影响及作用尚未知。”
Dr. Ramos-Nino and colleagues investigated the association of TZDs and cancer prevalence among nearly 9000 diabetic patients participating in the Vermont Diabetes Information System. A randomly selected sample of 1003 of these participants were interviewed about personal and clinical parameters, including any history of malignancy.
Ramos-Nino博士及其同事对参加佛蒙特州糖尿病信息系统的约9000名糖尿病患者进行调查，研究TZD和癌症发病间的联系。在这些参与者中随机选出1003名做为样本，调查其个人和临床情况，其中包括所有恶性肿瘤史。
The investigators found that the use of any TZD was associated with a 59% increased risk of cancer in a logistic regression model corrected for use of sulfonylureas and biguanides, age, HbA1c, BMI, smoking, comorbidity, and other medications.
研究者发现，在排除使用磺脲类和双胍类药物，排除年龄、HbA1c、 BMI指数、吸烟情况、合并其他疾病和使用其他药物等因素后，使用对数回归模型分析，结果显示任何一种噻唑烷二酮类药物都能使癌症风险增加59%。
There was a significant association with rosiglitazone use with an odds ratio of 1.89 (p = 0.02) for malignancy, but not with pioglitazone use (OR = 1.09, p = 0.76).
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作者:admin@医学,生命科学 2011-03-21 05:12
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