目的 从临床角度探讨2型糖尿病与恶性肿瘤的关系。方法 收集2011-01至2014-01住院2型糖尿病5205例临床资料,从中选择患恶性肿瘤215例为观察组,非肿瘤2型糖尿病215例为对照组。分析归纳恶性肿瘤在不同系统中的分布状况,对临床资料及降糖药物使用率进行对照。结果 观察组消化系统肿瘤占所有肿瘤发病的46.9%,其次是血液系统肿瘤占26%,呼吸系统肿瘤占24%,其他系统肿瘤占3.1%。消化系统肿瘤中又以胰腺癌的发病率最高。与对照组相比,男性、高龄、体重指数、糖化血红蛋白及空腹血糖为恶性肿瘤的危险因素。使用双胍、阿卡波糖及胰岛素药物降糖,发生恶性肿瘤的风险小;而使用磺脲类及联合用药对恶性肿瘤影响无统计学意义。结论 2型糖尿病可增加患恶性肿瘤的风险,有必要重视和加强降糖药物的远期安全性检测。
Abstract
Objective To investigate the correlation between type 2 diabetes and malignant tumor from the clinical point of view. Methods From January 2011 to January 2014 ,5205 hospitalized patients with type 2 diabetes,and 215 patients with malignant tumuor were recruited for the observation group; at the same time ,the same period 215 type 2 diabetic patients were recruited in the control group.Retrospective analysis was made of the distribution of induced malignant tumor in different systems. The clinical data and biochemical parameters were: age,sex.body mass index,antidiabetic drugs,fasting blood glucose,glycosylated hemoglobin. Results The incidence of digestive tract tumor was 46.9% of all tumors,then the blood system tumors accounted for 26%,accounting for 24% of the respiratory system tumors ,other tumors accounted for 3.1%.In the incidence of gastrointestinal tumor, pancreatic cancer ranked the highest.Compared with the control group,male,age,body mass index,glycosylated hemoglobin and fasting blood glucose were risk factors of malignant tumor. In the group using metformin,acarbose and insulin antidiabetic medication,the risk of malignant tumor was small, but there was no statistically significant difference in combined use of drugs and sulfonylurea. Conclusions Diabetes increases risk of cancer. Importance should be attached strengthening the detection of long-term safety of hypoglycemic agents.
关键词
2型糖尿病 /
恶性肿瘤 /
临床研究
Key words
type 2 diabetes /
malignant tumor /
clinical analysis
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参考文献
[1] Hemminki K,Li X,Sundquist J,et al. Risk of cancer following hospitalization for 2 diabetes[J]. Oncologist,2010,15(6):548.
[2] Giovannucci E,Harlan M D,Archer ,M C,et al. Diabetes and cancer:a consensus report [J] . CA Cancer J Clin,2010,60(4):207-221.
[3] 中华医学会糖尿病学分会.中国2型糖尿病防治指南-2010版[J]. 中华糖尿病杂志,2010,2 (增刊2):1-56.
[4] Alberti K G,Zimmer P . Epidemiology:Global burden of disease-where does diabetes mellitus fit in? [J]. Nat Rev Endocrinol,2013,9(5):258-260.
[5] Jemal A,Bray F,Center M M, et al. Global cancer statistics[J]. Clin,2011,61(2):69-90.
[6] Zhou J,Tao R,Lan F,et al. Inactivation of AMPK alters gene expression and promotes growth of prostate cancer cells[J]. Oncogene,2009,28 (18):1993-2002.
[7] 翁建平. 关注糖尿病与肿瘤[J]. 糖尿病天地(临床刊),2011,7 (5):310-311.
[8] Jee S H,AOhrr H, Sull J W,et al. Fasting serum glucose level and cancer risk in Korean men and women[J]. JAMA,2005,293(2):194-202.
[9] 韦 华,王民登.糖尿病与肿瘤关系研究现状[J]. 中外医学研究,2011,9(22):155-157.
[10] 肖 鹏,冯密罗,王留兴,等. 糖尿病并发恶性肿瘤45例临床分析[J]. 山东医药,2008,48(14):66-67.
[11] Renehan A G,Tyson M,Egger M,et al. Body-mass index and incidence of cancer: a systematic review and metaanalysis of prospective observational studies [J]. Lancet,2008,371 (9612):569-578.
[12] Yang Y X,Hemessy S,Lewis J D. Type 2 diabetes mellitus and the risk of colorectal cancer[J]. Clin Gastroenterol Hepalol,2005,3(6):587-594.
[13] Adams T D,Gress R E,Smith S C,et al. Long-term mortality after gastric bypass surgery [J]. N Engl J Med,2007,357(8):753-761.
[14] 王爱萍,刘 超,将克春,等.关于2型糖尿病患者合并恶性肿瘤临床特点的调查[J]. 南京医科大学学报(自然科学版),2009,29(1):102-105.
[15] Chari S T,Leibson C L,Rabe K G,et al. Probability of pancreatic cancer following diabetes: a population-based study[J]. Gastroenterology, 2005,129:504-511.
[16] DeMeo M T. Pancreatic cancer and suager diabetes[J]. Nutr Rev,2001,59(4):112-115.
[17] 王玉瑶,赵 立,顾鸣宇,等. 胰腺癌与糖尿病关联的探讨[J]. 中国癌症杂志,2006,16(11):973-975.
[18] Curri C I,Poole C D,Gale E A.The influence of glucose-lowering therapies on cancer risk in type 2 diabetes [J]. Diabetologia, 2009,52:1766-1777.
[19] 朱旭新, 陈永松. 糖尿病治疗与肿瘤风险的关系[J]. 药品评价,2011,8 (13):21-23.
[20] Yang X,Gary T C,Wing Y S. Associations of Hyperglycemia and Insulin Usage With the Risk of Cancer in Type 2 Diabetes:The Hong Kong Diabetes Registry[J]. Diabetes,2010,59:1254-1260.
[21] 武建英,邢惠莉,班华川. 2型糖尿病伴发恶性肿瘤患者临床特征分析[J]. 中国医师杂志,2011,13(9):1229-1230.
[22] 陈宇红. 糖尿病及其胰岛素治疗与肿瘤[J]. 内科理论与实践,2012,7(3):165-168.
[23] 韩丽媛,华启航,李球杰,等. 糖尿病与恶性肿瘤关系的研究进展[J]. 实用肿瘤学杂志,2013,27(5):440-443.
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