代谢减重手术可降低胰腺癌风险:对超过 370 万成年人的 Meta 分析,与 2 型糖尿病状态无关。

IF 4.6 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Angeliki M. Angelidi, Eirini G. Martinou, Dimitrios G. Karamanis
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引用次数: 0

摘要

目的:研究代谢减重手术(MBS)对基于2型糖尿病(T2D)状态的肥胖患者胰腺癌(PCa)风险的影响:我们按照《系统综述和荟萃分析首选报告项目》指南(PROSPERO:CRD42022367749)进行了系统综述和荟萃分析。主要结果是接受 MBS 治疗的 T2D 患者与对照组(非 MBS 组)相比的 PCa 发病率。根据 MBS 类型进行了分组分析,并采用了随机效应模型。应用 "留一 "荟萃分析技术进行了敏感性分析,并排除了随访时间较短的研究。异质性采用I2指数和Cochran's Q检验进行评估。发表偏倚采用 Egger 检验进行评估,偏倚风险采用 Cochrane Risk-of-Bias 工具进行评估:结果:共纳入了 12 项研究,3,711,243 人参与了研究。在T2D和总体人群中,MBS组的PCa风险均低于非MBS组(RR=0.46,95% CI:0.30-0.71和RR=0.21;95% CI:0.07-0.57),在排除有结论的研究后,结果一致:无论是否患有 T2D,MBS 都与 PCa 风险的降低有关,而对 T2D 患者的影响更为明显。需要进行更多的研究来探讨 MBS 类型对 PCa 的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Metabolic–Bariatric Surgery Reduces Pancreatic Cancer Risk: A Meta-Analysis of Over 3.7 Million Adults, Independent of Type 2 Diabetes Status

Metabolic–Bariatric Surgery Reduces Pancreatic Cancer Risk: A Meta-Analysis of Over 3.7 Million Adults, Independent of Type 2 Diabetes Status

Aims

To investigate the impact of Metabolic–Bariatric surgery (MBS) on pancreatic cancer (PCa) risk in individuals with obesity based on type 2 diabetes(T2D) status.

Materials and Methods

We conducted a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines (PROSPERO: CRD42022367749). The primary outcomes were the PCa incidence rates in participants with or without T2D who underwent MBS compared with the control (non-MBS) group. Subgroup analyses based on the MBS types were performed and a random-effects model was employed. Sensitivity analysis was conducted by applying the leave-one-out meta-analysis technique and excluding studies with a short follow-up. Heterogeneity was evaluated using the I2 index and Cochran's Q test. Publication bias was assessed with Egger's test and the risk of bias was assessed with the Cochrane Risk-of-Bias tool.

Results

Twelve studies, with 3,711,243 participants, were included. PCa risk was lower in the MBS group for both T2D and the overall population than in the non-MBS group (RR = 0.46, 95% CI: 0.30–0.71 and RR = 0.21; 95% CI: 0.07–0.57, respectively), with consistent findings after excluding studies with < 3-year follow-up. A favourable impact was also observed in individuals without T2D (RR = 0.56, 95% CI: 0.41–0.78). When comparing the types of MBS versus control, a significant difference was observed for sleeve gastrectomy (SG) (RR = 0.24; 95% CI, 0.12–0.46 for SG and RR = 0.52; 95% CI, 0.25–1.09 for Roux-En-Y bypass). Egger's test showed no indication of publication bias (p = 0.417).

Conclusions

MBS is associated with reduced PCa risk regardless of T2D, with a more pronounced effect in T2D patients. Additional research is needed to investigate the impact of MBS types on PCa.

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来源期刊
Diabetes/Metabolism Research and Reviews
Diabetes/Metabolism Research and Reviews 医学-内分泌学与代谢
CiteScore
17.20
自引率
2.50%
发文量
84
审稿时长
4-8 weeks
期刊介绍: Diabetes/Metabolism Research and Reviews is a premier endocrinology and metabolism journal esteemed by clinicians and researchers alike. Encompassing a wide spectrum of topics including diabetes, endocrinology, metabolism, and obesity, the journal eagerly accepts submissions ranging from clinical studies to basic and translational research, as well as reviews exploring historical progress, controversial issues, and prominent opinions in the field. Join us in advancing knowledge and understanding in the realm of diabetes and metabolism.
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