TY - JOUR
T1 - The influence of diabetes and antidiabetic medications on the risk of pancreatic cancer
T2 - A nationwide population-based study in Korea
AU - Lee, Da Young
AU - Yu, Ji Hee
AU - Park, Sanghyun
AU - Han, Kyungdo
AU - Kim, Nam Hoon
AU - Yoo, Hye Jin
AU - Choi, Kyung Mook
AU - Baik, Sei Hyun
AU - Kim, Nan Hee
AU - Seo, Ji A.
N1 - Funding Information:
This work was undertaken in cooperation with the National Health Insurance Service (NHIS) and the Korean Diabetes Association. The National Health Information Database created by NHIS was used (NHIS-2017-4-021). This research was supported by a National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIP) (No. 2015R1A2A2A01003167, 2015R1C1A2A01052010), and by a Korea University Grant (K1722341).
Publisher Copyright:
© 2018 The Author(s).
PY - 2018/12/1
Y1 - 2018/12/1
N2 - This study investigated the effects of diabetes and antidiabetic medications on the risk of pancreatic cancer(PaC). We extracted data on Koreans with newly diagnosed diabetes and selected age- and sex-matched controls provided by the National Health Insurance Corporation. Incident PaC was defined as a new registration in the Korea Central Cancer Registry under ICD-10 C25 with admission history until 2015. During 19,429,617.1 person-years, 8,589 PaCs were identified in 1,005,409 subjects for diabetes group and 4,021,636 subjects for control group. The diabetes group showed more than a two-fold risk for PaC compared with the control group. Among antidiabetic medications, metformin, thiazolidinedione, and dipeptidyl peptidase-4 inhibitor exposure was associated with decreased risk for future PaC(hazard ratio[95% confidence interval] = 0.86[0.77-0.96], 0.82[0.68-0.98], 0.57[0.51-0.64], respectively), whereas sulfonylurea and insulin exposure was related to increased risk(hazard ratio[95% CI] = 1.73[1.57-1.91], 2.86[1.43-5.74], respectively) compared to subjects with no drug exposure. Moreover, subjects with dual exposure history to metformin plus thiazolidinedione or metformin plus dipeptidyl peptidase-4 inhibitor had a lower risk of PaC compared to metformin-only treated subjects. In conclusion, Korean adults with diabetes are at higher risk of PaC compared with nondiabetic individuals, and this risk may be modified by antidiabetic medications.
AB - This study investigated the effects of diabetes and antidiabetic medications on the risk of pancreatic cancer(PaC). We extracted data on Koreans with newly diagnosed diabetes and selected age- and sex-matched controls provided by the National Health Insurance Corporation. Incident PaC was defined as a new registration in the Korea Central Cancer Registry under ICD-10 C25 with admission history until 2015. During 19,429,617.1 person-years, 8,589 PaCs were identified in 1,005,409 subjects for diabetes group and 4,021,636 subjects for control group. The diabetes group showed more than a two-fold risk for PaC compared with the control group. Among antidiabetic medications, metformin, thiazolidinedione, and dipeptidyl peptidase-4 inhibitor exposure was associated with decreased risk for future PaC(hazard ratio[95% confidence interval] = 0.86[0.77-0.96], 0.82[0.68-0.98], 0.57[0.51-0.64], respectively), whereas sulfonylurea and insulin exposure was related to increased risk(hazard ratio[95% CI] = 1.73[1.57-1.91], 2.86[1.43-5.74], respectively) compared to subjects with no drug exposure. Moreover, subjects with dual exposure history to metformin plus thiazolidinedione or metformin plus dipeptidyl peptidase-4 inhibitor had a lower risk of PaC compared to metformin-only treated subjects. In conclusion, Korean adults with diabetes are at higher risk of PaC compared with nondiabetic individuals, and this risk may be modified by antidiabetic medications.
UR - http://www.scopus.com/inward/record.url?scp=85049208252&partnerID=8YFLogxK
U2 - 10.1038/s41598-018-27965-2
DO - 10.1038/s41598-018-27965-2
M3 - Article
C2 - 29946194
AN - SCOPUS:85049208252
VL - 8
JO - Scientific Reports
JF - Scientific Reports
SN - 2045-2322
IS - 1
M1 - 9719
ER -
