Association between cancer prevalence and use of thiazolidinediones: results from the Vermont Diabetes Information System
Open accessAbstract
BACKGROUND: Peroxisome proliferator-activated receptors (PPARs) have emerged as important drug targets for diabetes. Drugs that activate PPARgamma, such as the thiazolidinediones (TZDs), are widely used for treatment of Type 2 diabetes mellitus. PPARgamma signaling could also play an anti-neoplastic role in several in vitro models, although conflicting results are reported from in vivo models. The effects of TZDs on cancer risk in humans needs to be resolved as these drugs are prescribed for long periods of time in patients with diabetes. METHODS: A total of 1003 subjects in community practice settings were interviewed at home at the time of enrolment into the Vermont Diabetes Information System, a clinical decision support program. Patients self-reported their personal and clinical characteristics, including any history of malignancy. Laboratory data were obtained directly from the clinical laboratory and current medications were obtained by direct observation of medication containers. We performed a cross-sectional analysis of the interviewed subjects to assess a possible association between cancer diagnosis and the use of TZDs. RESULTS: In a multivariate logistic regression model, a diagnosis of cancer was significantly associated with TZD use, even after correcting for potential confounders including other oral anti-diabetic agents (sulfonylureas and biguanides), age, glycosylated hemoglobin A1C, body mass index, cigarette smoking, high comorbidity, and number of prescription medications (odds ratio = 1.59, P = 0.04). This association was particularly strong among patients using rosiglitazone (OR = 1.89, P = 0.02), and among women (OR = 2.07, P = 0.01). CONCLUSION: These data suggest an association between TZD use and cancer in patients with diabetes. Further studies are required to determine if this association is causal.
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Three epidemiologic studies among patients with diabetes focused on all cancers combined or only on a limited number of cancer sites, and results were inconsistent.
“Three epidemiologic studies conducted among patients with diabetes focused on all cancers combined or only on a limited number of cancer sites, and results were inconsistent (104–106).”
From Diabetes and Cancer (2010) · cites this paper as [106]
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References 36 · Cited by 92
- Authors
- Ramos-Nino, M. E., MacLean, C. D., & Littenberg, B.
- Affiliations
- University of Vermont (US)
- Venue
- BMC Medicine
- Published
- 2007-06-21
- Volume
- 5
- Issue
- 1
- Pages
- 17-17
- ISSN
- 1741-7015 (ISSN-L)
- PMC
- PMC1934377
- OpenAlex
- W2076669023
- Cited by
- 92
- References
- 36
- Citations by year
- 2026: 1 · 2024: 1 · 2023: 1 · 2022: 2 · 2020: 2 · 2019: 3 · 2018: 4 · 2017: 2 · 2016: 2 · 2015: 5 · 2014: 5 · 2013: 8 · 2012: 10
- FWCI
- 4.72
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Ministère de l'Énergie et des Ressources Naturelles
- National Institutes of Health
- National Cancer Institute (K01CA104159)
- National Institute of Diabetes and Digestive and Kidney Diseases (K24DK068380, R01DK061167)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Peroxisome Proliferator-Activated Receptors
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Metabolism, Diabetes, and Cancer
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- thiazolidinediones, cancer risk, type 2 diabetes, rosiglitazone, PPARγ, antineoplastic effects, drug safety, women, oral antidiabetic drugs
- MeSH terms
- Rosiglitazone, Pioglitazone, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Female, Humans, Hypoglycemic Agents, Male, Middle Aged, Neoplasms, New Hampshire, New York, Vermont, Comorbidity, Causality, Prevalence, Multivariate Analysis, Logistic Models, Age Distribution, Sex Distribution, Thiazolidinediones
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