Metformin reduces gastric cancer risk in patients with type 2 diabetes mellitus

Tseng, Chin-Hsiao

doi:10.18632/aging.101019

Cited by 54 publications

(39 citation statements)

References 69 publications

(87 reference statements)

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“…The beneficial effects of metformin on GC prevention remains controversial as randomized clinical trials were lacking and previous observational studies yielded conflicting results. (10)(11)(12)(13)(14)(15)(16) Apart from the heterogeneity on definition of drug exposure, comparators and study design, failure to adjust for other important risk factors of GC including H. pylori infection, HbA1c level and concurrent medication use is likely the reason. 17To address these limitations, our study included only diabetic patients who were successfully treated for H. pylori at baseline.…”

Section: Discussionmentioning

confidence: 99%

“…While no association between metformin use and GC was reported by some studies, (10,11) others suggested a protective effect with varying effect estimates. (12)(13)(14)(15)(16) A recent meta-analysis (17) concluded that metformin decreased GC risk by 24% but there was a statistically significant heterogeneity among studies. More importantly, other important risk factors of GC including H. pylori infection and DM severity have not been adequately addressed in previous studies, potentially undermining the role of metformin on GC prevention.…”

Section: Introductionmentioning

confidence: 99%

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Metformin Use and Gastric Cancer Risk in Diabetic Patients After Helicobacter pylori Eradication

Cheung

Chan

Wong

et al. 2018

JNCI: Journal of the National Cancer Institute

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Background: Although prior studies showed metformin could reduce gastric cancer (GC) risk in patients with diabetes mellitus (DM), they failed to adjust for Helicobacter pylori infection and glycemic control. We aimed to investigate whether metformin reduced GC risk in H. pylori-eradicated diabetic patients and its association with glycemic control. Methods: This was a territory-wide cohort study using hospital registry database, recruiting all diabetic patients who were prescribed clarithromycin-based triple therapy for H. pylori infection from 2003 to 2012. Subjects were observed from H. pylori therapy prescription until GC diagnosis, death or end of study (December 2015). Exclusion criteria included GC diagnosed within first year of H. pylori therapy, prior history of GC or gastrectomy, and failure of H. pylori eradication. The hazard ratio (HR) of GC with metformin (defined as at least 180-day use) was estimated by Cox model with propensity score adjustment for covariates (age, sex, comorbidities, medications [including insulin], and time-weighted average hemoglobin A1c [HbA1c]). All statistical tests were two-sided. Results: During a median follow-up of 7.1 years (IQR:4.7-9.8), 37 (0.51%) of 7,266 diabetic patients developed GC at a median age of 76.4 years (IQR: 64.8-81.5 years). Metformin use was associated with a reduced GC risk (adjusted HR:0.49; 95% CI:0.24-0.98). There was a trend towards a lower GC risk with increasing duration (ptrend =0.01) and dose of metformin (ptrend=0.02). HbA1c level was not an independent risk factor for GC.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Metformin Use and Gastric Cancer Risk in Diabetic Patients After Helicobacter pylori Eradication

Cheung

Chan

Wong

et al. 2018

JNCI: Journal of the National Cancer Institute

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“…Patients with diabetes have an increased risk of gastric cancer (1,2), and metformin may protect against gastric cancer (3). This study investigated whether metformin might protect against Helicobacter pylori infection, an important risk factor of gastric cancer.…”

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confidence: 99%

Metformin and Helicobacter pylori Infection in Patients With Type 2 Diabetes

Tseng

2018

Diabetes Care

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“…Indeed, it has been recently shown in vitro and in vivo in a mouse infected-model, that metformin directly inhibited H. pylori growth. Furthermore, the epidemiological study performed on a Taiwanese diabetic population, suggested that metformin use was associated with a significantly reduced risk of H. pylori infection in a dose-response pattern [58]. These facts could indicate that metformin use decreases GC risk via its antibiotic effect against H. pylori.…”

Section: Metformin Has An Immune-mediated Antitumour Effectmentioning

confidence: 90%

The therapeutic potential of metformin in gastric cancer

2019

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Metformin is a biguanide molecule used since 1957 to treat type 2 diabetes patients. In addition to its hypoglycemic effects, epidemiological studies have shown that metformin can be associated with a decrease in cancer development risk in diabetic populations. Thus, since 2005 this molecule is largely studied for its antitumoural properties in different types of cancer. The potential antitumoural effect of metformin in gastric cancer has been poorly studied. Here, we detailed the different described mechanisms implicated in the antitumoural effect of metformin in gastric cancer, from the signalling pathways to the functional effects on gastric cancer cell lines and gastric cancer stem cells.Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Metformin reduces gastric cancer risk in patients with type 2 diabetes mellitus

Cited by 54 publications

References 69 publications

Metformin Use and Gastric Cancer Risk in Diabetic Patients After Helicobacter pylori Eradication

Metformin Use and Gastric Cancer Risk in Diabetic Patients After Helicobacter pylori Eradication

Metformin and Helicobacter pylori Infection in Patients With Type 2 Diabetes

The therapeutic potential of metformin in gastric cancer

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