2型糖尿病患者罹患生殖系统恶性肿瘤危险性的Meta分析

[目的]探讨2型糖尿病与生殖系统恶性肿瘤发生风险的关系。[方法]检索1979年1月至2012年10月Medline、Embase和Web of Science数据库公开发表的有关2型糖尿病与生殖系统恶性肿瘤关系的队列研究文献，按纳入和排除标准进行筛选，利用R软件及其Meta程序包对检索结果进行综合分析。[结果]共纳入39篇文献，包括10778543名观察对象。与非糖尿病人群相比，2型糖尿病患者发生生殖系统恶性肿瘤的合并相对危险度（RR）为1．15（95％CI：1．03～1．28）。2型糖尿病与女性生殖系统恶性肿瘤发生的相对危险度RR为l-39f95％CI：1．23－1．57）。2型糖尿病可以增加子宫内膜癌、宫颈癌和女性乳腺癌的发病风险，合并RR分别为1．83（95％CI：1．58-2．12）、2．13（95％CI：1．86－2．43）和1．16f95％CI：1．03-1.32）。卵巢癌风险的增加接近临界（RR=I．21，95％CI：0．99～1．48）；与前列腺癌的发病风险无关（RR=0．92，95％CI：0．78～1．09）。亚组分析提示，在欧美人群中2型糖尿病患者发生前列腺癌的风险降低．RR为0．80（95％CI：0．74－0．87）。[结论]2型糖尿病可能是子宫内膜癌、宫颈癌、乳腺癌的危险因素之一，可能是欧美人群前列腺癌保护因素。

Meta-Analysis of Type 2 Diabetes and the Risk of Reproductive System Malignancy

[Purposel To investigate the relationship between type 2 diabetes and the risk of reproductive system malignancy. [Methods] A Meta-analysis was conducted to evaluate the association between type 2 diabetes and the risk of reproductive system malignancy from cohort studies,which were identified through electronic search of Medline, Embase and Web of Science database within the time limit of January 1979 to June 2012 to estimate the pooled relative risks （RRs）. [Results] A total of 39 studies,involving 10 778 543 participants met the inclusion criteria. In total,the pooled RR of reproductive system malignancy was 1.15（95%CI： 1.03-1.28） for subjects with type 2 diabetes compared to those without diabetes. The pooled RR of reproductive system malignancy including ovarian,endometrial,cervical and breast cancer was 1.39 （95%CI： 1.23-1.57） for female subjects with type 2 diabetes. The results showed that type 2 diabetes increased the risk of endometrial cancer,cervical cancer and breast cancer with the pooled RRs of 1.83 （95%CI： 1.58- 2.12）, 2.13（95%CI ： 1.86-2.43） and 1.16（95%CI ： 1.03-1.32）. A borderline increase for ovarian can- cer with the pooled RR of 1.21（95%CI：0.99-1.48） was observed. There was a significant statistical risk of prostate cancer with the pooled RR of 0.92（95%CI ：0.78~1.09）. A reduced risk,RR of 0.80 （95%CI ：0.74-0.87） was observed for prostate cancer among European and American population in subgroup analysis. [Conclusion ] The Type 2 diabetes might be associated with the increased risk of endometrial, cervical and breast cancer, and decreased risk of prostate cancer among European and American population.