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Is Metformin Associated with a Lower Prevalence of Polyps, Adenomas, and Colorectal Carcinoma in Patients with Diabetes Mellitus?

2024-03Artigo científico Acesso aberto
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dc.contributor.authorCanha, Maria Inês
dc.contributor.authorRamos, Gonçalo
dc.contributor.authorPrata, Rita
dc.contributor.authorLages Martins, Pedro
dc.contributor.authorViúla Ramos, Marta
dc.contributor.authorCoimbra, João
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.pblSpringer
dc.date.accessioned2024-05-01T00:10:13Z
dc.date.available2024-05-01T00:10:13Z
dc.date.issued2024-03
dc.description.abstractPurpose: Recent studies suggested a protective role of metformin in the development of colorectal cancer (CRC) and its precursors. We aimed to investigate if metformin was associated with a lower prevalence and number of colorectal polyps in diabetic patients and also adenomas, high-risk adenomas, and CRC. Methods: Retrospective study on adult patients with diabetes mellitus followed in our hospital with a total colonoscopy between 2015 and 2019, treated with either metformin for > 5 years or other antidiabetic agent (control group). We assessed the number, size, and histopathology examination of proliferative lesions detected on colonoscopy. Results: We included 401 patients aged 69 ± 9 years, 57% males, divided into two groups: treated with metformin (n = 260) and without (n = 141). The number of polyps detected was significantly lower in patients under metformin (p = 0.014). There was a nonsignificant trend towards lower polyp detection rates in the metformin compared to the control group both in unadjusted analysis (50% vs 60%, p = 0.058) and multivariable adjusted analysis (odds ratio [OR] 0.68, 95% confidence interval [CI] 0.43–1.09, p = 0.111). In the latter, we identified male gender (OR 2.24, 95%CI 1.44–3.49, p < 0.001), age (OR 1.35 for every 10 years, 95%CI 1.07–1.71, p = 0.012), glycated hemoglobin value (OR 1.20 for every 1% increase, 95%CI 1.06–1.37, p = 0.005), and hypertension (OR 1.76, 95%CI 1.01–3.08, p = 0.046) as factors associated with a higher prevalence of polyps. We saw no statistically significant differences regarding adenoma (p = 0.231), high-risk adenoma (p = 0.810), and CRC (p = 0.705) diagnoses between groups. Conclusion: In our study, metformin was associated with less colorectal polyps in diabetic patients compared to other treatment modalities. We observed a nonsignificant trend towards lower polyp detection rates in the metformin group both in unadjusted and adjusted analyses.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent791428
dc.identifier.doi10.1007/s12029-023-00989-2
dc.identifier.issn1941-6628
dc.identifier.otherPURE: 77142262
dc.identifier.otherPURE UUID: 2aa0938b-6a45-4446-9194-94b303f91ced
dc.identifier.otherScopus: 85177466207
dc.identifier.otherWOS: 001105812700001
dc.identifier.urihttp://hdl.handle.net/10362/166829
dc.identifier.urlhttps://www.scopus.com/pages/publications/85177466207
dc.language.isoeng
dc.peerreviewedyes
dc.subjectColorectal adenomas
dc.subjectColorectal carcinoma
dc.subjectColorectal polyps
dc.subjectDiabetes mellitus
dc.subjectMetformin
dc.subjectOncology
dc.subjectGastroenterology
dc.subjectSDG 3 - Good Health and Well-being
dc.titleIs Metformin Associated with a Lower Prevalence of Polyps, Adenomas, and Colorectal Carcinoma in Patients with Diabetes Mellitus?en
dc.typejournal article
degois.publication.firstPage435
degois.publication.issue1
degois.publication.lastPage443
degois.publication.titleJournal of gastrointestinal cancer
degois.publication.volume55
dspace.entity.typePublication
rcaap.rightsopenAccess

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