Effect of metformin on thyroid cancer risk in patients with acromegaly: A preliminary observational study

IF 1.6 4区医学 Q4 CELL BIOLOGY

Growth Hormone & Igf Research Pub Date : 2022-10-01 DOI:10.1016/j.ghir.2022.101484

Cem Sulu , Ayyuce Begum Bektas , Suleyman Sami Guzel , Kubilay Tay , Serdar Sahin , Emre Durcan , Hande Mefkure Ozkaya , Pinar Kadioglu

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引用次数: 1

Abstract

Purpose

To evaluate the role of metformin on thyroid cancer risk in patients with acromegaly.

Methods

Medical charts of 534 patients with acromegaly that were followed-up between 1983 and 2019 were reviewed. Patients with follow-up duration at least 6 months were included. Cohort entry was defined as first visit date. The date of each case's thyroid cancer diagnosis was defined as index date. Patients were followed until the index date, death, or last visit date, whichever came first. Nested case-control study design was selected to evaluate the association between metformin and the thyroid cancer risk in patients with acromegaly.

Results

291 patients with acromegaly were included into final analysis. The mean age at acromegaly diagnosis was 42.3 ± 1.3 years. The median follow-up duration was 76 [34–132] months. Among 291 patients, 13 patients (4.5%) had thyroid cancer. Thirty-one percent (n = 92) of the patients used metformin for 6 months or longer. One standard deviation (SD) increase in average growth hormone increased the odds of having thyroid cancer by 1.164 folds (p = 0.017). One SD increase of the average insulin-like growth factor 1 to upper limit of normal ratio increased the odds of having thyroid cancer by 1.201 folds (p = 0.004). If a patient used metformin for at least 6 months, the odds to have thyroid cancer was decreased, multiplied by 0.62 with a 95% confidence interval of [0.47, 0.83] (p = 0.0013). The risk of thyroid cancer decreased with increasing duration of metformin use.

Conclusion

Metformin may decrease the thyroid cancer risk in patients with acromegaly.

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二甲双胍对肢端肥大患者甲状腺癌风险的影响:一项初步观察研究

目的探讨二甲双胍对肢端肥大症患者甲状腺癌发病的影响。方法回顾性分析1983 ~ 2019年534例肢端肥大症患者的病历资料。纳入随访时间至少6个月的患者。队列输入定义为首次访问日期。每个病例的甲状腺癌诊断日期被定义为索引日期。随访患者至索引日期、死亡日期或最后一次就诊日期，以先到者为准。采用巢式病例对照研究设计，评价二甲双胍与肢端肥大症患者甲状腺癌风险的关系。结果291例肢端肥大症患者纳入最终分析。肢端肥大症的平均诊断年龄为42.3±1.3岁。中位随访时间为76[34-132]个月。291例患者中有13例(4.5%)患有甲状腺癌。31% (n = 92)的患者使用二甲双胍6个月或更长时间。平均生长激素每增加一个标准差(SD)，患甲状腺癌的几率增加1.164倍(p = 0.017)。胰岛素样生长因子1平均比正常比值上限每增加一个标准差，患甲状腺癌的几率增加1.201倍(p = 0.004)。如果患者使用二甲双胍至少6个月，患甲状腺癌的几率降低，乘以0.62,95%置信区间为[0.47,0.83](p = 0.0013)。甲状腺癌的风险随着二甲双胍使用时间的增加而降低。结论二甲双胍可降低肢端肥大症患者患甲状腺癌的风险。

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

Growth Hormone & Igf Research 医学-内分泌学与代谢

CiteScore

3.30

自引率

0.00%

发文量

审稿时长

57 days

期刊介绍： Growth Hormone & IGF Research is a forum for research on the regulation of growth and metabolism in humans, animals, tissues and cells. It publishes articles on all aspects of growth-promoting and growth-inhibiting hormones and factors, with particular emphasis on insulin-like growth factors (IGFs) and growth hormone. This reflects the increasing importance of growth hormone and IGFs in clinical medicine and in the treatment of diseases.