Comparisons of the risks of new-onset prostate cancer in type 2 diabetes mellitus between SGLT2I and DPP4I users: A population-based cohort study

IF 4.6 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism Pub Date : 2024-08-23 DOI:10.1016/j.diabet.2024.101571

Oscar Hou In Chou , Lei Lu , Cheuk To Chung , Jeffrey Shi Kai Chan , Raymond Ngai Chiu Chan , Athena Yan Hiu Lee , Edward Christopher Dee , Kenrick Ng , Hugo Hok Him Pui , Sharen Lee , Bernard Man Yung Cheung , Gary Tse , Jiandong Zhou

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引用次数: 0

Abstract

Background

Sodium-glucose cotransporter 2 inhibitors (SGLT2I) have been suggested to reduce new-onset cancer amongst type-2 diabetes mellitus (T2DM) patients. This study aims to compare the risks of prostate cancer between SGLT2I and dipeptidyl peptidase-4 inhibitors (DPP4I) amongst T2DM patients.

Design, setting and participants

This was a retrospective population-based cohort study of prospectively recorded data on male patients with T2DM who were prescribed either SGLT2I or DPP4I between 1^st January 2015 and 31^st December 2020 from Hong Kong.

Methods

The primary outcome was new-onset prostate cancer. The secondary outcomes included cancer-related mortality and all-cause mortality. Propensity score matching (1:1 ratio) using the nearest neighbor search was performed and multivariable Cox regression was applied. A three-arm analysis including the glucagon-like peptide-1 receptor agonist (GLP1a) cohort was conducted.

Results

This study included 42129 male T2DM patients (median age: 61.0 years old [SD: 12.2]; SGLT2I: n = 17,120; DPP4I: n = 25,009). In the propensity score matched cohort, the number of prostate cancers was significantly lower in SGLT2I users (n = 60) than in DPP4I (n = 102). Over a follow-up duration of 5.61 years, SGLT2I was associated with lower prostate cancer risks (HR: 0.45; 95% CI: 0.30-0.70) than DPP4I after adjustments. The subgroup analyses showed that the interactions between SGLT2I and age, hypertension, heart failure, and GLP-1a were not statistically significant. The result remained consistent in the sensitivity analysis.

Conclusion

The study demonstrated SGLT2I was associated with lower risks of new-onset prostate cancer after propensity score matching and adjustments compared to DPP4I amongst T2DM patients.

Abstract Image

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SGLT2I和DPP4I使用者新发2型糖尿病前列腺癌风险的比较：一项基于人群的队列研究。

背景：钠-葡萄糖共转运体2抑制剂（SGLT2I）被认为可减少2型糖尿病（T2DM）患者新发癌症。本研究旨在比较SGLT2I和二肽基肽酶-4抑制剂（DPP4I）在T2DM患者中的前列腺癌风险：这是一项以人群为基础的回顾性队列研究，研究对象是香港在2015年1月1日至2020年12月31日期间处方SGLT2I或DPP4I的T2DM男性患者：主要结果为新发前列腺癌。次要结果包括癌症相关死亡率和全因死亡率。采用最近邻搜索进行倾向评分匹配（1:1 比例），并应用多变量 Cox 回归。进行了包括胰高血糖素样肽-1受体激动剂（GLP1a）队列在内的三臂分析：该研究纳入了 42129 名男性 T2DM 患者（中位年龄：61.0 岁 [标码：12.2]；SGLT2I：n = 17120；DPP4I：n = 25009）。在倾向得分匹配队列中，SGLT2I 使用者（n = 60）的前列腺癌数量明显低于 DPP4I 使用者（n = 102）。在 5.61 年的随访期间，经调整后，SGLT2I 的前列腺癌风险（HR：0.45；95% CI：0.30-0.70）低于 DPP4I。亚组分析表明，SGLT2I 与年龄、高血压、心力衰竭和 GLP-1a 之间的相互作用无统计学意义。这一结果在敏感性分析中保持一致：研究表明，与 DPP4I 相比，经过倾向评分匹配和调整后，SGLT2I 与 T2DM 患者中新发前列腺癌的风险更低相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes & metabolism 医学-内分泌学与代谢

CiteScore

12.00

自引率

4.20%

发文量

审稿时长

13 days

期刊介绍： A high quality scientific journal with an international readership Official publication of the SFD, Diabetes & Metabolism, publishes high-quality papers by leading teams, forming a close link between hospital and research units. Diabetes & Metabolism is published in English language and is indexed in all major databases with its impact factor constantly progressing. Diabetes & Metabolism contains original articles, short reports and comprehensive reviews.