The influence of diabetes and antidiabetic medications on the risk of pancreatic cancer: A nationwide population-based study in Korea

Da Young Lee, Ji Hee Yu, Sanghyun Park, Kyungdo Han, Nam Hoon Kim, Hye-Jin Yoo, Kyung Mook Choi, Sei-Hyun Baik, Nan Hee Kim, Ji A Seo

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Abstract

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.

Original languageEnglish
Article number9719
JournalScientific Reports
Volume8
Issue number1
DOIs
Publication statusPublished - 2018 Dec 1

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Korea
Pancreatic Neoplasms
Hypoglycemic Agents
Metformin
Dipeptidyl-Peptidase IV Inhibitors
Population
History
Control Groups
National Health Programs
International Classification of Diseases
Registries
Odds Ratio
Confidence Intervals
Insulin
Pharmaceutical Preparations
Neoplasms

ASJC Scopus subject areas

  • General

Cite this

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title = "The influence of diabetes and antidiabetic medications on the risk of pancreatic cancer: A nationwide population-based study in Korea",
abstract = "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.",
author = "Lee, {Da Young} and Yu, {Ji Hee} and Sanghyun Park and Kyungdo Han and Kim, {Nam Hoon} and Hye-Jin Yoo and Choi, {Kyung Mook} and Sei-Hyun Baik and Kim, {Nan Hee} and Seo, {Ji A}",
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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

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.

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