Dose effect of thiazolidinedione on cancer risk in type 2 diabetes mellitus patients

A six-year population-based cohort study

H. C. Lin, Y. T. Hsu, B. H. Kachingwe, Chung-Yi Hsu, Y. S. Uang, L. H. Wang

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

What is known and objective Prior studies found that thiazolidinediones (TZDs) might have tumour-suppressor activity mediated through cell-cycle arrest, induction of apoptosis and inhibition of cell invasion. The main objective of this study was to investigate the effects of TZDs on the risk of cancer among patients with type 2 diabetes mellitus (DM). Methods Patients diagnosed with DM between 1 January 1998 and 31 December 2002 were identified from the Longitudinal Health Insurance Database (LHID) within the Taiwan National Health Insurance (NHI) programme. Using Cox regression models, we assessed the association between prescribed TZDs and cancer risk, TZDs' dose effect and the association between TZDs and specific cancer types. Hazard ratios (HR) were adjusted for potential confounders (age, gender, income, Charlson score index, metformin and insulin use). Results and discussion The adjusted HRs for those prescribed TZD were 0·74 (95% CI 0·43-1·26, P = 0·27), 0·39 (95% CI 0·33-0·45, P <0·001) and 0·49 (95% CI 0·27-0·89, P = 0·02), respectively, relative to non-DM patients, DM patients prescribed other anti-DM drugs besides TZDs and DM patients not prescribed any anti-DM drugs. In addition, the effects of TZDs were shown to be significantly dose dependent (P for trend <0·001). The risk of breast, brain, colorectal, ear-nose-throat, kidney, liver, lung, lymphatic, prostate, stomach, and uterus cancer was significantly lower in those prescribed TZDs. What is new and conclusions The results showed a decrease in cancer risk in diabetic patients using TZD, and the association was dose dependent. The main objective of this study was to investigate the effects of TZDs on the risk of cancer among patients with type 2 diabetes mellitus (DM). The results showed a decrease in cancer risk in diabetic patients using TZD, and the association was dose-dependent.

Original languageEnglish
Pages (from-to)354-360
Number of pages7
JournalJournal of Clinical Pharmacy and Therapeutics
Volume39
Issue number4
DOIs
Publication statusPublished - 2014

Fingerprint

Thiazolidinediones
Type 2 Diabetes Mellitus
Cohort Studies
Population
Neoplasms
Diabetes Mellitus
National Health Programs
2,4-thiazolidinedione
Uterine Neoplasms
Metformin
Health Insurance
Pharynx
Cell Cycle Checkpoints
Taiwan
Nose
Proportional Hazards Models
Pharmaceutical Preparations
Stomach Neoplasms
Ear
Lung Neoplasms

Keywords

  • cancer risk
  • cohort study
  • dose effect
  • thiazolidinedione
  • type 2 diabetes mellitus

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology
  • Medicine(all)

Cite this

Dose effect of thiazolidinedione on cancer risk in type 2 diabetes mellitus patients : A six-year population-based cohort study. / Lin, H. C.; Hsu, Y. T.; Kachingwe, B. H.; Hsu, Chung-Yi; Uang, Y. S.; Wang, L. H.

In: Journal of Clinical Pharmacy and Therapeutics, Vol. 39, No. 4, 2014, p. 354-360.

Research output: Contribution to journalArticle

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abstract = "What is known and objective Prior studies found that thiazolidinediones (TZDs) might have tumour-suppressor activity mediated through cell-cycle arrest, induction of apoptosis and inhibition of cell invasion. The main objective of this study was to investigate the effects of TZDs on the risk of cancer among patients with type 2 diabetes mellitus (DM). Methods Patients diagnosed with DM between 1 January 1998 and 31 December 2002 were identified from the Longitudinal Health Insurance Database (LHID) within the Taiwan National Health Insurance (NHI) programme. Using Cox regression models, we assessed the association between prescribed TZDs and cancer risk, TZDs' dose effect and the association between TZDs and specific cancer types. Hazard ratios (HR) were adjusted for potential confounders (age, gender, income, Charlson score index, metformin and insulin use). Results and discussion The adjusted HRs for those prescribed TZD were 0·74 (95{\%} CI 0·43-1·26, P = 0·27), 0·39 (95{\%} CI 0·33-0·45, P <0·001) and 0·49 (95{\%} CI 0·27-0·89, P = 0·02), respectively, relative to non-DM patients, DM patients prescribed other anti-DM drugs besides TZDs and DM patients not prescribed any anti-DM drugs. In addition, the effects of TZDs were shown to be significantly dose dependent (P for trend <0·001). The risk of breast, brain, colorectal, ear-nose-throat, kidney, liver, lung, lymphatic, prostate, stomach, and uterus cancer was significantly lower in those prescribed TZDs. What is new and conclusions The results showed a decrease in cancer risk in diabetic patients using TZD, and the association was dose dependent. The main objective of this study was to investigate the effects of TZDs on the risk of cancer among patients with type 2 diabetes mellitus (DM). The results showed a decrease in cancer risk in diabetic patients using TZD, and the association was dose-dependent.",
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