Association of metformin and statin uses with the prognosis of colon cancer: a meta-analysis
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Background Metformin and statins are commonly used globally for the treatment of type 2 diabetes mellitus and dyslipidemia, respectively. Recently, multiple novel pathways have been discovered, which may contribute to the treatment of various types of cancer. Several meta-analysis studies have reported that the use of metformin or statins is associated with a lower risk of colon cancer compared to nonusers. In this study, our aim was to perform a meta-analysis and investigate the prognostic roles of these two medications in colon cancer. Methods To identify relevant articles, literature searches were performed in the PubMed and Web of Science databases using a combination of keywords related to metformin, statins and colon cancer prognosis until August 2023. The study utilized STATA 12.0 software (Stata Corporation, College Station, Texas, USA) to compute all the hazard ratios (HRs) and 95% confidence intervals (CIs) regarding the association between metformin or statin uses and prognostic-related outcomes. Results Our analysis revealed that the use of metformin was associated with a significantly lower overall mortality of colon cancer (HR = 0.63; 95% CI = 0.51–0.77; I 2 = 94.9%; P < 0.001), as well as lower cancer-specific mortality of colon cancer (HR = 0.68; 95% CI = 0.50–0.94; I 2 = 91.9%; P < 0.001). Similarly, the use of statins was also associated with a lower overall mortality of colon cancer (HR = 0.68; 95% CI = 0.60–0.78; I 2 = 93.8%; P < 0.001), as well as a lower cancer-specific mortality of colon cancer (HR = 0.74; 95% CI = 0.67–0.81; I 2 = 82.2%; P < 0.001). Conclusion Our meta-analysis study suggests that statins and metformin may have potential as adjuvant agents with significant benefits in the prognosis of colon cancer.Keywords:
Dyslipidemia
Background: India has seen an ever increasing number of diabetic patients and in turn rise in cardiovascular diseases. Many studies have shown diabetic patients to have dyslipidemia, with certain common patterns early in the disease. Aims and Objective: The current study was done to identify pattern of dyslipidemia and prevalence of ADD in treatment naïve diabetic patients. Material and Methods: Fasting lipid profile was analysed in treatment naïve diabetic patients at a tertiary care teaching hospital. Various factors influencing the results were analysed statistically. Results: Prevalence of dyslipidemia was 89.2%, whereasatherogenic diabetic dyslipidemia was seen in 34.2% and raised non-HDL cholesterol in 73.3%. Conclusion: Our study showed a high prevalence of dyslipidemia in newly diagnosed diabetics indicating the importance of screening for dyslipidemia in newly diagnosed cases and implementation of timely lipid lowering therapy to prevent CVD. It also highlights the importance of pattern of dyslipidemia called Atherogenic diabetic dyslipidemia and raised Non-HDL cholesterol in diabetic patients.
Dyslipidemia
Lipid Profile
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목적: 급성 호흡곤란 증후군은 높은 사망률을 보이지만, 저환기요법 외에는 입증된 치료법이 부족한 실정이고, 염증 반응 억제를 통한 치료법은 실패한 상황이다. 경구용 혈당강하제인 metformin이 항염 작용이 있다고 보고되었으나 급성 호흡곤란 증후군의 예후에 미치는 영향은 알려져 있지 않아 이를 알아보고자 하였다. 방법: 2005년 1월 1일부터 2015년 4월 30일까지 서울대학교병원 내과계중환자실에 입실한 급성 호흡곤란 증후군 환자 중 당뇨가 동반된 환자들을 후향적으로 분석하였다. 입원 전 3개월 내 metformin 처방된 경우 metformin 사용군으로 정의되었다. Propensity score matching 후 30일 사망률을 분석하였다. 성적: 당뇨가 동반된 급성 호흡곤란 증후군 환자 128명들 중 metformin 사용군은 33명이었다. Propensity score matching 후 30일 사망률은 metformin 사용군에서 낮았으나 통계적 유의성은 없었다 (42.4 vs. 56.4%, P=0.265). Ventilator free days 와 ICU free days 도양군간 차이는 없었다. 다변량 회귀분석에서 metformin 사용 여부는 30일 사망률을 감소시키는 경향을 보였으나, 역시 통계적인 유의성은 없었다 (s-coefficient -0.19, 95% CI -1.76-1.39, P=0.816). 결론: 중환자실 입실 이전 사용된 metformin 은 급성 호흡곤란 증후군 환자의 사망률을 감소시키는 경향을 보였으나 통계적으로 유의하지는 않았다.
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Metformin was rediscover during the hunt for an antimalarial drug. The French physician Jean Sterne, who first reported the use of metformin to treat diabetes in 1957. Aim: Over View of Metformin. The commonly used medication metformin has definite advantages in terms of issues related to diabetes and glucose metabolism.
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Metformin is an oral hypoglycemic agent that is commonly used in the treatment of type 2 diabetes mellitus. While metformin-associated metabolic acidosis is a widely recognized side effect of this drug, metformin-induced hepatotoxicity has been rarely reported in the literature. We present herein the case of a 52-year-old male in whom metformin-associated lactic acidosis and metformin-induced hepatotoxicity developed.
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OBJECTIVE To provide evidences for prevention and treatment of dyslipidemia from analyzing dyslipidemia distribution in staff at government departments in Hefeng country. METHODS The results of examination of 5 043 subjects at government departments were analyzed. RESULTS 2 563 of 5 043 subjects (50.82%), 22 to 91 years old, were with dyslipidemia. There was a significant difference in blood lipid level between subjects with dyslipidemia and normal subjects (P﹤0.05). The prevalence of dyslipidemia in males was higher than in females (P﹤0.05). CONCLUSION Dyslipidemia is correlated with age and gender, which suggests that a reasonable diet, physical activity are beneficial to prevention and treatment of dyslipidemia.
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As a safe and effective antidiabetic drug , metformin has been considered to be the first line drug for the therapy of diabetes. With further research on metformin, it turns out that metformin can not only lower blood glucose but also display certain benefits for patients with polycystic ovary syndrome and nonalcoholic fatty liver disease, which is independent of the hypoglycemic effect of metformin. Furthermore, metformin can block cancer cells growth by activation of AMP-activated protein kinase and inhibition of mammalian target of rapamycin signaling pathway. In recent years, the effects of metformin on anti-atherosclerosis, endothelial function protection and other cardiovascular benefits have also become a research hotspot.
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To evaluate evidence from the medical literature that metformin is effective in preventing type 2 diabetes.Primary literature was accessed via a MEDLINE search (1966-December 2003) using the terms metformin, type 2 diabetes, and prevention.Two studies evaluated metformin's potential to prevent type 2 diabetes, finding that metformin maintained or reduced fasting blood glucose in non-diabetics. Recently, a large study by the Diabetes Prevention Program showed that metformin may reduce the incidence of diabetes. Researchers compared lifestyle changes, metformin therapy, and placebo groups. They found that both lifestyle changes (58%) and metformin therapy (31%) significantly reduced the occurrence of type 2 diabetes versus placebo.These studies provide evidence that metformin may reduce the occurrence of type 2 diabetes. Because long-term efficacy has not been determined, further studies are needed.
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Metformin is the most widely prescribed drug to treat patients with type II diabetes, for whom retrospective studies suggest that metformin may have anticancer properties. However, in experiments performed with isolated cells, authors have reported both pro- and anti-apoptotic effects of metformin. The exact molecular mechanism of action of metformin remains partly unknown despite its use for over 60 years and more than 17,000 articles in PubMed. Among the various widely recognized or recently proposed targets, it has been reported consistently that metformin is capable of inhibiting mitochondrial respiratory chain Complex I. Since most of the effects of metformin have been replicated by other inhibitors of Complex I, it has been suggested that the mechanism of action of metformin involved the inhibition of Complex I. However, compared to conventional Complex I inhibitors, the metformin-induced inhibition of Complex I has unique characteristics. Among these, the most original one is that the concentrations of metformin required to inhibit Complex I are lower in intact cells than in isolated mitochondria. Experiments with isolated cells, mitochondria or Complex I were generally performed using millimolar concentrations of metformin, while plasma levels remain in the micromolar range in both human and animal studies, highlighting that metformin concentration is an important issue. In order to explain the effects in animals based on observations in cells and mitochondria, some authors proposed a direct effect of the drug on Complex I involving an accumulation of metformin inside the mitochondria while others proposed an indirect effect (the drug no longer having to diffuse into the mitochondria). This brief review attempts to: gather arguments for and against each hypothesis concerning the mechanism by which metformin inhibits Complex I and to highlight remaining questions about the toxicity mechanism of metformin for certain cancer cells.
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Dyslipidemia
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목적: Metformin은 암 발생 위험 및 사망률을 낮추는 효과가 있다. 당뇨를 동반한 4기 대장암 환자에서 metformin의 효과는 알려져 있지 않으며, 이번 연구는 당뇨를 동반한 4기 대장암 환자에서 항암약물요법 반응 및 생존율에 대한 metformin의 효과를 후향적으로 알아보고자 하였다. 대상 및 방법: 당뇨를 동반한 4기 대장암으로 진단된 106명의 환자 중 완화항암약물치료를 받은 81명의 환자와 근치적 수술을 시행한 25명의 환자를 대상으로 후향적 연구를 하였다. 각 군에서 metformin 사용여부에 따라 대상 환자의 임상적 특징 및 종양반응, 생존율 등을 조사하여 비교하였다. 결과: 완화항암약물요법을 시행한 환자군에서 metformin 복용군과 비복용군으로 나누어 단변량 및 다변량 분석을 시행한 결과, 항암약물요법 후 첫 번째 반응평가, 표적 병변의 크기 변화율, 무진행 생존율, 전체 생존율은 차이가 없었다. 근치적수술 환자군에서 무병 생존율은 metformin 복용군이 비복용군에 비하여 높았고(p=0.012), 다변량 분석에서도 암 재발률이 유의하게 적었다(HR, 0.024; 95% CI 0.001-0.435; p=0.010). 그러나 전체 생존율에서는 차이가 없었다. 결론: 당뇨를 동반한 4기 대장직장암 환자에서 근치적 수술 후 metformin을 복용하는 것은 암 재발률을 감소시키는 효과를 나타냈다.
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