英国《临床内分泌和代谢》杂志最新刊登来自中国的一项研究提示，服二甲双胍能降低2型糖尿病患者得肝癌的风险。
糖尿病患者比普通人的患肿瘤风险要高1.2—2.5倍，其中肝癌风险增加约1倍。因此在控制血糖水平的同时，降低肿瘤风险也一直是提高糖尿病患者生活质量的重要研究课题。上海交通大学公共卫生学院张志将博士综合分析了5项研究、涉及近10.5万例病例后发现，服二甲双胍的糖尿病患者得肝癌风险明显低于未服二甲双胍的患者。
目前，二甲双胍是治疗2型糖尿病患者的一线药物，特别是对超重而伴有高胰岛素血症的患者疗效好。而新研究提示，它的好处可能更多。
Metformin for Liver Cancer Prevention in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis
Zhi-Jiang Zhang, Zhi-Jie Zheng, Rong Shi, Qing Su, Qingwu Jiang and Kevin E. Kip
Context: Data on the potential effect of metformin on the risk of liver cancer are limited and inconsistent.
Objective: The objective of this study was to review the evidence currently available to examine the potential role of metformin in chemoprevention for liver cancer in patients with type 2 diabetes.
Data Sources: The data sources of the study included the PubMed and SciVerse Scopus databases.
Study Selection: Selection included studies that assessed the effect of metformin therapy on the risk of liver cancer in patients with type 2 diabetes.
Data Extraction: Summary effect estimates were derived using a random-effects meta-analysis model.
Data Synthesis: A database was developed on the basis of five studies consisting of approximately 105,495 patients with type 2 diabetes. In meta-analyses, metformin was associated with an estimated 62% reduction in the risk of liver cancer among patients with type 2 diabetes (odds ratio 0.38, 95% confidence interval 0.24, 0.59; P < 0.001). The effect estimates were heterogeneous across the five included studies (P for heterogeneity = 0.001; I2 = 78%). When restricting the analysis to the four studies related to hepatocellular carcinoma, metformin was again associated with a significantly lower cancer risk (odds ratio 0.30, 95% confidence interval 0.17, 0.52; P < 0.001), and there was evidence of significant heterogeneity between these four studies (P for heterogeneity = 0.03; I2 = 67%).
Conclusions: Metformin appears to be associated with a lower risk of liver cancer in patients with type 2 diabetes. Further investigation, including mechanistic studies, well-designed cohort studies, and possibly controlled trials, is needed.
