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Metformin shows chemopreventive potential in Asians with diabetes

23 Nov 2020

Metformin use staves off the risk of developing stomach cancer in a Korean cohort of patients with diabetes mellitus (DM), a study reports.

The population comprised 347,895 Koreans (53.5 percent male), among whom 9,891 (mean age, 56.7 years) had diabetes and used metformin while 14,922 (mean age, 54.4 years) were nonusers; the remaining 323,082 (mean age, 51.7 years) were assigned as non-DM controls.

Individuals with DM, regardless of metformin exposure, were more likely to have higher body mass index, glucose levels, alanine transaminase levels, hypertension history, and lower household income compared with controls.

Over a median follow-up of 12.7 years, 5,621 stomach cancers occurred—74 percent in men and 26 percent in women. Metformin nonusers had the highest estimated cumulative incidence of stomach cancer (men vs women: 3.75 percent vs 1.97 percent), whereas controls logged the lowest (2.54 percent vs 0.95 percent). The corresponding rates among metformin users were 2.91 percent in men and 1.53 percent in women.

Multivariable Cox analysis confirmed that both metformin users and controls had a lower risk of developing stomach cancer compared with nonusers. Use of the glucose-lowering drug reduced the risk by about 30 percent in men (hazard ratios [HR], 0.710, 95 percent confidence interval [CI], 0.579–0.870) and women (HR, 0.700, 95 percent CI, 0.499–0.981). The corresponding HRs in controls were 0.879 (95 percent CI, 0.767–1.006) and 0.701 (95 percent CI, 0.544–0.903).

Although unclear, the anticarcinogenic effect of metformin was postulated to be partly mediated by AMPK activation and immune modulation through the mammalian target of rapamycin. [Diabetologia 2017;60:1577-1585; Clin Sci 2012;122:253-270]

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Most Read Articles
10 Jan 2021
Regular practice of yoga postures confers benefits for glucose control, oxidative stress, inflammatory response, and sleep quality in patients with type 2 diabetes, a study has found.
01 Dec 2020
Tetanus toxoid 5 Lf, diphtheria toxoid 2 Lf, pertussis toxoid 2.5 mcg, filamentous haemagglutinin 5 mcg, fimbriae types 2 and 3 5 mcg, pertactin 3 mcg
Dr. Hsu Li Yang, Dr. Tan Thuan Tong, Dr. Andrea Kwa, 08 Jan 2021
Antimicrobial resistance has become increasingly dire as the rapid emergence of drug resistance, especially gram-negative pathogens, has outpaced the development of new antibiotics. At a recent virtual symposium, Dr Hsu Li Yang, Vice Dean (Global Health) and Programme Leader (Infectious Diseases), NUS Saw Swee Hock School of Public Health, presented epidemiological data on multidrug-resistant (MDR) gram-negative bacteria (GNB) in Asia, while Dr Tan Thuan Tong, Head and Senior Consultant, Department of Infectious Diseases, Singapore General Hospital (SGH), focused on the role of ceftazidime-avibactam in MDR GNB infections. Dr Andrea Kwa, Assistant Director of Research, Department of Pharmacy, SGH, joined the panel in an interactive fireside chat, to discuss challenges, practical considerations, and solutions in MDR gram-negative infections. This Pfizer-sponsored symposium was chaired by Dr Ng Shin Yi, Head and Senior Consultant of Surgical Intensive Care, SGH.
Pearl Toh, 26 Nov 2020
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