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目的甘精胰岛素能增加糖尿病(diabetes Mellitus,DM)患者患前列腺癌(prostate cancer,PCa)风险,但这些研究的结果具有争议性。因此,我们进行了Meta分析,以确定甘精胰岛素是否会增加DM患者PCa的发病率。方法检索Pubmed、Cochrane library和EMbase 3个数据中2000年至2016年的英文文献,收集了甘精胰岛素与DM患者PCa发病风险的相关研究,按纳入与排除标准筛选,并对纳入文献进行质量评价。应用Rev Man 5.0软件,用固定效应模型或随机效应模型计算相对风险(RR)和相应的95%可信区间(CI),同时进行亚组分析。结果15篇文献纳入Meta分析,研究对象有647 517人,其中PCa患者有6 049人。甘精胰岛素与非甘精胰岛素相比,在引起PCa发病率上没有显著差异(RR=1.00,95%CI=0.93~1.08,I2=0%,P=0.95)。结论我们分析的结果表明:甘精胰岛素与非甘精胰岛素相比,不会明显增加2型DM患者患PCa的发病率。但DM患者PCa的发生还受DM严重程度、种族等多种因素的影响,需要更进一步的研究证实。
Purpose Glargine increases the risk of prostate cancer (PCa) in patients with diabetes mellitus (DM), but the results of these studies are controversial. Therefore, we performed a meta-analysis to determine if glargine increased the incidence of PCa in DM patients. Methods The English literature of Pubmed, Cochrane Library and EMbase was searched from 2000 to 2016 in Pubmed, Cochrane Library and EMbase. The relevant literature was collected on the risk of PCa between insulin glargine and DM patients. The screening criteria for inclusion and exclusion were included, and the quality of the included literature was evaluated . Rev Man 5.0 software was used to calculate the relative risk (RR) and the corresponding 95% confidence interval (CI) using a fixed-effects model or random effects model with subgroup analysis. Results Fifteen articles were included in the meta-analysis, with 647 517 participants, of whom 6 049 were PCa. There was no significant difference in the incidence of PCa between insulin glargine and non-insulin glargine (RR = 1.00, 95% CI = 0.93-1.08, I2 = 0%, P = 0.95). Conclusions Our results show that glargine does not significantly increase the incidence of PCa in patients with type 2 DM compared with non-insulin glargine. However, the occurrence of PCa in DM patients is also affected by the severity of DM, race and other factors, and needs further study to confirm.