{"title":"二肽基肽酶-4抑制剂对2型糖尿病患者结直肠癌发病率的影响：一项系统综述和荟萃分析","authors":"Rongrong Fu, Jingqi Chen, Yingying Fang, Qingping Wu, Xiaoming Zhang, Zhiyan Wang","doi":"10.1177/20420986251318842","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The association between dipeptidyl peptidase-4 inhibitors (DPP-4i) exposure and the risk of colorectal cancer (CRC) in patients with type 2 diabetes mellitus (T2DM) is unclear.</p><p><strong>Objectives: </strong>This meta-analysis aims to investigate the relationship between DPP-4i exposure and the incidence of CRC in patients with T2DM.</p><p><strong>Design: </strong>A systematic review and meta-analysis.</p><p><strong>Methods: </strong>A comprehensive search of electronic databases, including PubMed, Web of Science, EMBASE, and ScienceDirect, was conducted up to March 2024. The studies including randomized clinical trials (RCTs), cohort studies, and case-control studies were retrieved. The odds ratio (OR) was calculated using Stata 12.0 statistical software. The primary outcome assessed was the incidence of CRC.</p><p><strong>Results: </strong>This meta-analysis incorporated six retrospective cohort studies and two case-control studies. The findings indicate that the incidence of CRC in the DPP-4i exposure group was significantly higher than that in the control group (OR = 1.11, 95% CI: 1.02-1.21, <i>p</i> = 0.013). Subgroup analysis revealed that both male (OR = 2.07, <i>p</i> < 0.001) and female participants (OR = 1.49, <i>p</i> = 0.05) in the DPP-4i exposure group exhibited a significantly higher incidence of CRC compared to the control group. Among participants younger than 65 years, the incidence of CRC was markedly elevated in the exposure group (OR = 2.81, <i>p</i> < 0.001). Furthermore, when the exposure duration was less than 1 year, the CRC incidence in the exposure group surpassed that of the control group (OR = 1.24, <i>p</i> = 0.005). When sulfonylureas (SU) were used as control drugs, the incidence of CRC was higher in the exposure group (OR = 1.10, <i>p</i> = 0.017).</p><p><strong>Conclusion: </strong>There is a potential correlation between DPP-4i exposure and increased incidence of CRC in T2DM patients. This association appears to be influenced by gender, age, duration of exposure, and the choice of control medications. Therefore, attention should be paid to colorectal diseases when DPP-4i is employed in the clinic.</p><p><strong>Trial registration: </strong>The meta-analysis has been registered with the International Prospective Register of Systematic Reviews (PROSPERO). The registration number is CRD42024535292.</p>","PeriodicalId":23012,"journal":{"name":"Therapeutic Advances in Drug Safety","volume":"16 ","pages":"20420986251318842"},"PeriodicalIF":3.4000,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837066/pdf/","citationCount":"0","resultStr":"{\"title\":\"Impact of dipeptidyl peptidase-4 inhibitors on incidence of colorectal cancer in patients with type 2 diabetes mellitus: a systematic review and meta-analysis.\",\"authors\":\"Rongrong Fu, Jingqi Chen, Yingying Fang, Qingping Wu, Xiaoming Zhang, Zhiyan Wang\",\"doi\":\"10.1177/20420986251318842\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The association between dipeptidyl peptidase-4 inhibitors (DPP-4i) exposure and the risk of colorectal cancer (CRC) in patients with type 2 diabetes mellitus (T2DM) is unclear.</p><p><strong>Objectives: </strong>This meta-analysis aims to investigate the relationship between DPP-4i exposure and the incidence of CRC in patients with T2DM.</p><p><strong>Design: </strong>A systematic review and meta-analysis.</p><p><strong>Methods: </strong>A comprehensive search of electronic databases, including PubMed, Web of Science, EMBASE, and ScienceDirect, was conducted up to March 2024. The studies including randomized clinical trials (RCTs), cohort studies, and case-control studies were retrieved. The odds ratio (OR) was calculated using Stata 12.0 statistical software. The primary outcome assessed was the incidence of CRC.</p><p><strong>Results: </strong>This meta-analysis incorporated six retrospective cohort studies and two case-control studies. The findings indicate that the incidence of CRC in the DPP-4i exposure group was significantly higher than that in the control group (OR = 1.11, 95% CI: 1.02-1.21, <i>p</i> = 0.013). Subgroup analysis revealed that both male (OR = 2.07, <i>p</i> < 0.001) and female participants (OR = 1.49, <i>p</i> = 0.05) in the DPP-4i exposure group exhibited a significantly higher incidence of CRC compared to the control group. Among participants younger than 65 years, the incidence of CRC was markedly elevated in the exposure group (OR = 2.81, <i>p</i> < 0.001). Furthermore, when the exposure duration was less than 1 year, the CRC incidence in the exposure group surpassed that of the control group (OR = 1.24, <i>p</i> = 0.005). When sulfonylureas (SU) were used as control drugs, the incidence of CRC was higher in the exposure group (OR = 1.10, <i>p</i> = 0.017).</p><p><strong>Conclusion: </strong>There is a potential correlation between DPP-4i exposure and increased incidence of CRC in T2DM patients. This association appears to be influenced by gender, age, duration of exposure, and the choice of control medications. Therefore, attention should be paid to colorectal diseases when DPP-4i is employed in the clinic.</p><p><strong>Trial registration: </strong>The meta-analysis has been registered with the International Prospective Register of Systematic Reviews (PROSPERO). 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引用次数: 0
摘要
背景：二肽基肽酶-4抑制剂（DPP-4i）暴露与2型糖尿病（T2DM）患者结直肠癌（CRC）风险之间的关系尚不清楚。目的：本荟萃分析旨在探讨DPP-4i暴露与T2DM患者CRC发病率之间的关系。设计：系统回顾和荟萃分析。方法：全面检索截至2024年3月的PubMed、Web of Science、EMBASE、ScienceDirect等电子数据库。研究包括随机临床试验（RCTs）、队列研究和病例对照研究。比值比（OR）采用Stata 12.0统计软件计算。评估的主要结局是CRC的发生率。结果：本荟萃分析纳入了6项回顾性队列研究和2项病例对照研究。结果显示，DPP-4i暴露组的CRC发病率显著高于对照组（OR = 1.11, 95% CI: 1.02-1.21, p = 0.013）。亚组分析显示，与对照组相比，DPP-4i暴露组的男性（OR = 2.07, p p = 0.05）均表现出更高的CRC发病率。在年龄小于65岁的参与者中，暴露组CRC的发病率明显升高（OR = 2.81, p = 0.005）。以磺脲类（SU）作为对照药物时，暴露组CRC发病率较高（OR = 1.10, p = 0.017）。结论：DPP-4i暴露与T2DM患者CRC发病率增加存在潜在的相关性。这种关联似乎受到性别、年龄、暴露时间和对照药物选择的影响。因此，临床上应用DPP-4i时应注意结肠疾病。试验注册：该荟萃分析已在国际前瞻性系统评价注册（PROSPERO）上注册。注册号为CRD42024535292。
Impact of dipeptidyl peptidase-4 inhibitors on incidence of colorectal cancer in patients with type 2 diabetes mellitus: a systematic review and meta-analysis.
Background: The association between dipeptidyl peptidase-4 inhibitors (DPP-4i) exposure and the risk of colorectal cancer (CRC) in patients with type 2 diabetes mellitus (T2DM) is unclear.
Objectives: This meta-analysis aims to investigate the relationship between DPP-4i exposure and the incidence of CRC in patients with T2DM.
Design: A systematic review and meta-analysis.
Methods: A comprehensive search of electronic databases, including PubMed, Web of Science, EMBASE, and ScienceDirect, was conducted up to March 2024. The studies including randomized clinical trials (RCTs), cohort studies, and case-control studies were retrieved. The odds ratio (OR) was calculated using Stata 12.0 statistical software. The primary outcome assessed was the incidence of CRC.
Results: This meta-analysis incorporated six retrospective cohort studies and two case-control studies. The findings indicate that the incidence of CRC in the DPP-4i exposure group was significantly higher than that in the control group (OR = 1.11, 95% CI: 1.02-1.21, p = 0.013). Subgroup analysis revealed that both male (OR = 2.07, p < 0.001) and female participants (OR = 1.49, p = 0.05) in the DPP-4i exposure group exhibited a significantly higher incidence of CRC compared to the control group. Among participants younger than 65 years, the incidence of CRC was markedly elevated in the exposure group (OR = 2.81, p < 0.001). Furthermore, when the exposure duration was less than 1 year, the CRC incidence in the exposure group surpassed that of the control group (OR = 1.24, p = 0.005). When sulfonylureas (SU) were used as control drugs, the incidence of CRC was higher in the exposure group (OR = 1.10, p = 0.017).
Conclusion: There is a potential correlation between DPP-4i exposure and increased incidence of CRC in T2DM patients. This association appears to be influenced by gender, age, duration of exposure, and the choice of control medications. Therefore, attention should be paid to colorectal diseases when DPP-4i is employed in the clinic.
Trial registration: The meta-analysis has been registered with the International Prospective Register of Systematic Reviews (PROSPERO). The registration number is CRD42024535292.
期刊介绍：
Therapeutic Advances in Drug Safety delivers the highest quality peer-reviewed articles, reviews, and scholarly comment on pioneering efforts and innovative studies pertaining to the safe use of drugs in patients.
The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in drug safety, providing a forum in print and online for publishing the highest quality articles in this area. The editors welcome articles of current interest on research across all areas of drug safety, including therapeutic drug monitoring, pharmacoepidemiology, adverse drug reactions, drug interactions, pharmacokinetics, pharmacovigilance, medication/prescribing errors, risk management, ethics and regulation.
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