Reetta Arima1, Mikko Marttila2, Ari Hautakoski3, Martti Arffman4, Reijo Sund5, Pirjo Ilanne-Parikka6, Jenni Kangaskokko7, Esa Läärä8, Ulla Puistola9, Marianne Hinkula10. 1. Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu and University Hospital of Oulu, P.O. Box 23, FIN-90029 Oulu, Finland. Electronic address: reetta.arima@gmail.com. 2. Children, Adolescents and Families Unit, Department of Welfare, National Institute for Health and Welfare, P.O. Box 310, FIN-90101 Oulu, Finland. Electronic address: mikko@mikkomarttila.com. 3. Children, Adolescents and Families Unit, Department of Welfare, National Institute for Health and Welfare, P.O. Box 310, FIN-90101 Oulu, Finland. 4. Service System Research Unit, National Institute for Health and Welfare, P.O. Box 30, FIN-00271 Helsinki, Finland. Electronic address: martti.arffman@thl.fi. 5. Centre for Research Methods, Department of Social Research, University of Helsinki, Helsinki, Finland; Institute of Clinical Medicine, University of Eastern Finland, P.O. Box 1627, FIN-70211 Kuopio, Finland. Electronic address: reijo.sund@helsinki.fi. 6. Science Center, Tampere University Hospital, Tampere, Finland; The Diabetes Center, Finnish Diabetes Association, FIN-33680 Tampere, Finland. Electronic address: pirjo.ilanne-parikka@diabetes.fi. 7. Department of Pathology, Medical Research Center Oulu, University of Oulu and University Hospital of Oulu, P.O. Box 50, FIN-90029 Oulu, Finland. Electronic address: jenni.kangaskokko@ppshp.fi. 8. Research Unit of Mathematical Sciences, University of Oulu, P.O. Box 8000, FIN-90014 Oulu, Finland. Electronic address: esa.laara@oulu.fi. 9. Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu and University Hospital of Oulu, P.O. Box 23, FIN-90029 Oulu, Finland. Electronic address: ulla.puistola@oulu.fi. 10. Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu and University Hospital of Oulu, P.O. Box 23, FIN-90029 Oulu, Finland. Electronic address: marianne.hinkula@oulu.fi.
Abstract
OBJECTIVE: To gain further evidence of an association between the incidence of endometrial cancer (EC) and the use of metformin, other antidiabetic medication (ADM) and statins in women with type 2 diabetes (T2D). METHODS: A retrospective cohort of 92,366 women with newly diagnosed T2D was obtained from a diabetes register (FinDM). 590 endometrioid ECs were observed during the follow-up time. Poisson regression was utilized to estimate the hazard ratios (HRs) with 95% confidence intervals (95% CIs) of the endometrioid EC in relation to the use of metformin, other oral ADM, insulin and statins. Nested case-control analyses were performed, where up to 20 controls were matched for age and duration of DM for each EC case. The HRs were estimated by conditional logistic regression for never/ever and cumulative use of different forms of ADM and statins. RESULTS: In the case-control analyses the use of metformin (HR 1.24, 95% CI 1.02-1.51) and other oral ADM (HR 1.25, 95% CI 1.04-1.50) was associated with an increased incidence of endometrioid EC compared to no ADM use. No difference was observed between metformin users and those using other oral ADMs. The use of statins was inversely related to the incidence of endometrioid EC (HR 0.78, 95% CI 0.65-0.94). Results from the full cohort analysis supported this finding. CONCLUSIONS: In our study the use of metformin or other oral forms of ADM was not associated with a lowered risk of endometrioid EC in women with T2D. Instead statins were observed to be inversely associated with endometrioid EC in this population.
OBJECTIVE: To gain further evidence of an association between the incidence of endometrial cancer (EC) and the use of metformin, other antidiabetic medication (ADM) and statins in women with type 2 diabetes (T2D). METHODS: A retrospective cohort of 92,366 women with newly diagnosed T2D was obtained from a diabetes register (FinDM). 590 endometrioid ECs were observed during the follow-up time. Poisson regression was utilized to estimate the hazard ratios (HRs) with 95% confidence intervals (95% CIs) of the endometrioid EC in relation to the use of metformin, other oral ADM, insulin and statins. Nested case-control analyses were performed, where up to 20 controls were matched for age and duration of DM for each EC case. The HRs were estimated by conditional logistic regression for never/ever and cumulative use of different forms of ADM and statins. RESULTS: In the case-control analyses the use of metformin (HR 1.24, 95% CI 1.02-1.51) and other oral ADM (HR 1.25, 95% CI 1.04-1.50) was associated with an increased incidence of endometrioid EC compared to no ADM use. No difference was observed between metformin users and those using other oral ADMs. The use of statins was inversely related to the incidence of endometrioid EC (HR 0.78, 95% CI 0.65-0.94). Results from the full cohort analysis supported this finding. CONCLUSIONS: In our study the use of metformin or other oral forms of ADM was not associated with a lowered risk of endometrioid EC in women with T2D. Instead statins were observed to be inversely associated with endometrioid EC in this population.
Authors: Piotr Olcha; Anna Winiarska-Mieczan; Małgorzata Kwiecień; Łukasz Nowakowski; Andrzej Miturski; Andrzej Semczuk; Bożena Kiczorowska; Krzysztof Gałczyński Journal: Int J Mol Sci Date: 2022-06-16 Impact factor: 6.208
Authors: Elina Urpilainen; Anne Ahtikoski; Reetta Arima; Ulla Puistola; Peeter Karihtala Journal: Front Pharmacol Date: 2021-05-13 Impact factor: 5.810
Authors: Hao Wu; Vikram Norton; Kui Cui; Bo Zhu; Sudarshan Bhattacharjee; Yao Wei Lu; Beibei Wang; Dan Shan; Scott Wong; Yunzhou Dong; Siu-Lung Chan; Douglas Cowan; Jian Xu; Diane R Bielenberg; Changcheng Zhou; Hong Chen Journal: Front Cardiovasc Med Date: 2022-02-17