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Association between metformin and the risk of gastric cancer in patients with type 2 diabetes mellitus: a meta-analysis of cohort studies

Xue-Liang Zhou, Wen-Hua Xue, Xian-Fei Ding, Li-Feng Li, Meng-Meng Dou, Wei-Jie Zhang, Zhuan Lv, Zhi-Rui Fan, Jie Zhao and Liu-Xing Wang _

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Oncotarget. 2017; 8:55622-55631. https://doi.org/10.18632/oncotarget.16973

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Abstract

Xue-Liang Zhou1,*, Wen-Hua Xue2,*, Xian-Fei Ding3, Li-Feng Li1, Meng-Meng Dou4, Wei-Jie Zhang1, Zhuan Lv1, Zhi-Rui Fan1, Jie Zhao2 and Liu-Xing Wang1

1 De­partment of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China

2 Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China

3 Department of General ICU, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China

4 Department of Integrated Traditional and Western Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China

* These authors have contributed equally to this work

Correspondence to:

Liu-Xing Wang, email:

Jie Zhao, email:

Keywords: gastric cancer, metformin, type 2 diabetes mellitus, risk, meta-analysis

Received: December 01, 2016 Accepted: March 13, 2017 Published: April 08, 2017

Abstract

Objectives: The objective of this study was to evaluate the association between metformin therapy and the incidence of gastric cancer (GC) in patients with type 2 diabetes mellitus (T2DM).

Methods: We systemically searched the following databases for studies published between the databases’ dates of inception and Nov. 2016: PubMed, Embase, the Cochrane Library, the Web of Science, and the China National Knowledge Infrastructure (CNKI). Hazard ratios (HR)and corresponding 95% confidence intervals (CIs) for the association between metformin therapy and the incidence of GC in patients with T2DM were the outcome measures assessed in this study. STATA 12.0 (Stata Corporation, College Station, Texas, USA) was used to conduct the statistical analysis.

Results: A total of seven cohort studies including 591,077 patients met all the criteria for inclusion in the analysis. Our data showed that metformin therapy was associated with a significantly lower incidence of GC in patients with T2DM than other types of therapy (HR=0.763, 95% CI: 0.642~0.905). Subgroup analysis showed that patients living in Taiwan benefitted more from metformin therapy than patients living in any other region, as metformin significantly decreased the risk of GC in patients living in Taiwan but did not significantly decrease the risk of GC in patients living in other regions (HR=0.514, 95% CI: 0.384-0.688). The results of the present analysis support the idea that metformin facilitates reductions in the risk of T2DM-related GC.

Conclusions: The risk of GC among patients with T2DM is lower in patients receiving metformin therapy than in patients not receiving metformin therapy.


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