SGLT2抑制剂与COPD合并2型糖尿病患者肺癌风险降低相关
Reduced Risk of Lung Cancer Associated with Sodium-Glucose Cotransporter-2 Inhibitors in Patients with COPD and Type 2 Diabetes Mellitus.
作者
作者单位
- Center for Clinical Epidemiology, Samsung Medical Center, Seoul, South Korea; Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea; Trend sensing & risk modeling center, institution of cancer quality of life, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, South Korea.
- Center for Clinical Epidemiology, Samsung Medical Center, Seoul, South Korea; Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea.
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea.
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. Electronic address: hyeyunpark@skku.edu.
摘要
中文
慢性阻塞性肺疾病（COPD）与肺癌风险增加相关，2型糖尿病（T2DM）是COPD患者常见的合并症。钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂除降糖作用外还具有多效性。然而，其与COPD合并T2DM患者肺癌风险的关联尚不明确。SGLT2抑制剂的使用是否与COPD合并T2DM患者肺癌发生风险降低相关？我们利用国民健康保险数据库开展了一项全国性人群队列研究，纳入2014年9月至2023年12月期间启动SGLT2抑制剂或磺脲类药物治疗的≥40岁COPD合并T2DM成人。主要终点为新发肺癌，次要终点包括重度COPD急性加重和全因死亡。共纳入14927例患者（SGLT2抑制剂组5651例，磺脲类组9276例），中位随访2.97年期间发生234例新发肺癌事件。SGLT2抑制剂组和磺脲类组4年累积肺癌发病率分别为1.6%和2.7%。与磺脲类相比，启动SGLT2抑制剂与新发肺癌风险降低相关（IPTW HR 0.73；95% CI 0.60–0.90）。SGLT2抑制剂使用还与重度COPD急性加重风险降低（IPTW HR 0.77；95% CI 0.71–0.83）和全因死亡风险降低（IPTW HR 0.81；95% CI 0.75–0.88）相关。在该全国性COPD合并T2DM患者队列中，启动SGLT2抑制剂与肺癌、COPD急性加重及全因死亡风险降低相关。
English
Chronic obstructive pulmonary disease (COPD) is associated with an increased risk of lung cancer, and type 2 diabetes mellitus (T2DM) is a common comorbidity in COPD patients. Sodium-glucose cotransporter-2 (SGLT2) inhibitors have pleiotropic effects beyond glucose lowering. However, their association with lung cancer risk in patients with COPD and T2DM remains uncertain. Is SGLT2 inhibitor initiation associated with a lower risk of incident lung cancer in patients with COPD and T2DM? We conducted a nationwide population-based cohort study using the National Health Insurance Database, including adults aged ≥40 years with COPD and T2DM who initiated SGLT2 inhibitors or sulfonylureas between September 2014 and December 2023. The primary outcome was incident lung cancer. Secondary outcomes included severe COPD exacerbation and all-cause mortality. Among 14,927 patients (5,651 SGLT2 inhibitor initiators and 9,276 sulfonylurea initiators), 234 incident lung cancer events occurred during a median follow-up of 2.97 years. The 4-year cumulative incidence of lung cancer was 1.6% in the SGLT2 inhibitor group and 2.7% in the sulfonylurea group. Initiation of SGLT2 inhibitors was associated with a lower risk of incident lung cancer compared with sulfonylureas (IPTW HR 0.73; 95% CI, 0.60-0.90). SGLT2 inhibitor use was also associated with reduced risks of severe COPD exacerbation (IPTW HR 0.77; 95% CI, 0.71-0.83) and all-cause mortality (IPTW HR 0.81; 95% CI, 0.75-0.88). In this nationwide cohort of patients with COPD and T2DM, initiation of SGLT2 inhibitors was associated with lower risks of lung cancer, COPD exacerbation, and all-cause mortality compared with sulfonylureas.
分类与指标
- 研究类型
- 临床研究
- 病种
- 肺癌
- JCR 分区
- Q1
- 影响因子
- 9.8
- 新锐分区
- 1区