Use of Thiazolidinediones and the Risk of Colorectal Cancer in Patients With Diabetes
A nationwide, population-based, case-control study
- Shih-Wei Chen, MD1,2,
- Yu-Tse Tsan, MD, MS1,3,4,
- Jong-Dar Chen, MD, MS1,5,6,
- Hui-I Hsieh, MD, PHD1,5,7,
- Chang-Hsing Lee, MD, PHD1,8,
- Hsien-Ho Lin, MD, SCD9,10,
- Jung-Der Wang, MD, SCD11,
- Pau-Chung Chen, MD, PHD1,10,12⇓ and
- Health Data Analysis in Taiwan Research Group
- 1Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan
- 2Department of Family Medicine, Hsinchu Cathay General Hospital, Hsinchu, Taiwan
- 3Division of Toxicology, Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- 4School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- 5School of Medicine, College of Medicine, Fu Jen Catholic University, Taipei, Taiwan
- 6Department of Occupational Medicine and Family Medicine, Shin-Kong Wu-Ho-Su Memorial Hospital, Taipei, Taiwan
- 7Department of Occupational Medicine and Family Medicine, Cathay General Hospital, Taipei, Taiwan
- 8Department of Occupational Medicine, Ton Yen General Hospital, Hsinchu, Taiwan
- 9Institute of Epidemiology and Preventive Medicine, National Taiwan University College of Public Health, Taipei, Taiwan
- 10Department of Public Health, National Taiwan University College of Public Health, Taipei, Taiwan
- 11Department of Public Health, National Cheng Kung University College of Medicine and Hospital, Tainan, Taiwan
- 12Department of Environmental and Occupational Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
- Corresponding author: Pau-Chung Chen, .
OBJECTIVE Preclinical data suggest that peroxisome proliferator–activated receptor γ (PPARγ) agonists have antineoplastic effects in colorectal cancer. We aimed to assess the association between the use of synthetic PPARγ agonists, represented by thiazolidinediones (TZDs), and the risk of developing colorectal cancer.
RESEARCH DESIGN AND METHODS We conducted a nationwide, population-based, case-control study using the Taiwan National Health Insurance Research Database. Case subjects were defined as patients who were diagnosed with diabetes at least 365 days prior to a new diagnosis of colorectal cancer between 2000 and 2008. We randomly selected diabetic control subjects for each case subject, which were matched by sex, age, and the duration of diabetes. Among the 24,496 eligible case subjects and control subjects, we used conditional logistic regression to assess the risk of colorectal cancer in association with the use of TZDs. An additional analysis was conducted to assess the effects of concomitant use of TZDs and low-dose aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) on the risk of colorectal cancer.
RESULTS A decreased risk of colorectal cancer was observed in patients who had used TZDs compared with those who had never used TZDs (adjusted odds ratio 0.86 [95% CI 0.79–0.94]). Furthermore, the benefit of a decreased colorectal cancer risk was also found with concomitant use of TZDs and low-dose aspirin or NSAIDs.
CONCLUSIONS The use of TZDs may be associated with a decreased risk of colorectal cancer in patients with diabetes. Further studies are warranted to confirm our findings.
The interpretation and conclusions in this article do not represent those of the BNHI, the Department of Health, or the NHRI.
- Received November 18, 2011.
- Accepted July 31, 2012.
- © 2012 by the American Diabetes Association.
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