PDF(Pubmed)
Abstract：
Lung cancer (LC) is the second most common cancer and the leading cause of cancer deaths in the U.S. Insulin therapy, a key treatment for managing Type 2 Diabetes Mellitus (T2DM), is associated with increased LC risk. The impact of non-insulin antidiabetic drugs, particularly GLP-1 receptor agonists (GLP-1RAs), on LC risk is not well understood. This study evaluated LC risk in T2DM patients, comparing seven non-insulin antidiabetic agents to insulin. Using the TriNetX Analytics platform, we analyzed the de-identified electronic health records of 1,040,341 T2DM patients treated between 2005 and 2019, excluding those with prior antidiabetic use or LC diagnoses. We calculated hazard ratios and confidence intervals for LC risk and used propensity score matching to control for confounding factors. All non-insulin antidiabetic drugs, except alpha-glucosidase inhibitors, were associated with significantly reduced LC risk compared to insulin, with GLP-1RAs showing the greatest reduction (HR: 0.49, 95% CI: 0.41, 0.59). GLP-1RAs were consistently associated with lowered LC risk across all histological types, races, genders, and smoking statuses. These findings suggest that non-insulin antidiabetic drugs, particularly GLP-1RAs, may be preferable for managing T2DM while reducing LC risk.
摘要：
肺癌（LC）是美国胰岛素治疗中第二常见的癌症，也是导致癌症死亡的主要原因。管理2型糖尿病（T2DM）的关键治疗方法，与LC风险增加相关。非胰岛素抗糖尿病药物的影响，特别是GLP-1受体激动剂（GLP-1RAs），对LC的风险还没有很好的理解。这项研究评估了T2DM患者的LC风险，比较七种非胰岛素抗糖尿病药物与胰岛素。使用TriNetXAnalytics平台，我们分析了2005年至2019年期间接受治疗的1,040,341例T2DM患者的去识别电子健康记录,不包括先前使用过抗糖尿病药物或LC诊断的患者.我们计算了LC风险的风险比和置信区间，并使用倾向评分匹配来控制混杂因素。所有非胰岛素抗糖尿病药物,除了α-葡萄糖苷酶抑制剂，与胰岛素相比，LC风险显著降低，GLP-1RAs显示最大的降低（HR：0.49，95%CI：0.41，0.59）。GLP-1RA与所有组织学类型的LC风险降低一致相关，种族,性别,和吸烟状况。这些结果表明，非胰岛素抗糖尿病药物，特别是GLP-1RA，在降低LC风险的同时管理T2DM可能是优选的。
