摘要目的 评价2型糖尿病(T2DM)患者中肠促胰素药物与胰腺癌风险的相关性.方法检索PubMed、Embase、The Cochrane Central Register及ClininalTrials.gov网站自2007年1月至2017年9月间所有肠促胰素药物(胰高血糖素样肽1受体激动剂或二肽基肽酶Ⅳ抑制剂)治疗T2DM的随机对照试验.采用RevMan5.3软件对入选人群的胰腺癌风险进行Meta分析.结果 入选12项试验(包括6项心血管结局研究),共计71942例T2DM患者,其中118例患者报告胰腺癌事件.与对照组相比,肠促胰素药物治疗组不增加胰腺癌风险(OR=0.73,95% CI:0.51~1.05).然而在治疗和随访≥104周的患者中,肠促胰素药物治疗组的胰腺癌风险似乎更低(OR=0.70,95% CI:0.48~1.00).结论 对于T2DM患者,肠促胰素药物与胰腺癌风险增加未见相关性.对于治疗≥104周的患者,该类药物可能是胰腺癌的保护性因素.

abstractsObjective To evaluate the risk of pancreatic cancer with incretin drugs in patients with type 2 diabetes mellitus (T2DM). Methods Pubmed, Embase, Cochrane Central Register and Clininal Trials.gov were used for searching randomized controlled trials of incretin drugs (glucagon-like peptide-1 receptor agonists or dipeptidyl peptidase-4 inhibitors)in the treatment of T2DM from Jan.2007 to Sept.2017.Meta-analysis was performed by using RevMan 5.3 to assess the risk of pancreatic cancer. Results Of total 12 trials (n=71 942), including 6 cardiovascular outcome trials, 118 pancreatic cancer were identified.Compared with placebo or other antidiabetic drugs,pancreatic cancer was not increased in patients treated with incretin drugs (OR=0.73, 95% CI: 0.51-1.05). Notably, following up for over 104 weeks, pancreatic cancer seemed to be lower in patients with incretin therapy (OR=0.70, 95% CI:0.48-1.00). Conclusion Incretin therapy is not associated with increased risk of pancreatic cancer in patients with T2DM.Instead,it might be a protective factor for pancreatic cancer in T2DM patients treated for over 104 weeks.