The Association of Metformin, Other Antidiabetic Medications, and Statins With the Prognosis of Colon Cancer in Patients With Type 2 Diabetes: A Retrospective Cohort Study

Association of metformin and statin uses with the prognosis of colon cancer: a meta-analysis

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; I2  = 94.9%; P  < 0.001), as well as lower cancer-specific mortality of colon cancer (HR = 0.68; 95% CI = 0.50-0.94; I2  = 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; I2  = 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; I2  = 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.

Effect of hyperglycemia on the occurrence and prognosis of colorectal cancer

Hyperglycemic status is associated with the development and prognosis of colorectal cancer (CRC), although the exact mechanisms are not fully understood. Hyperglycemia can promote the development of CRC by influencing cell proliferation and apoptosis, inflammatory responses, oxidative stress, immunomodulation, angiogenesis, and other pathways. In terms of prognosis, hyperglycemia may affect the survival and recurrence of CRC patients as well as chemotherapy resistance, but the results of related studies are not consistent. Hypoglycemic treatment may have a positive impact on the prognosis of CRC patients, but its specific effects need further research. Therefore, this article systematically explores the relationship between hyperglycemia and CRC, analyzes the impact of hyperglycemia on the occurrence and prognosis of CRC, and discusses the role of managing hyperglycemia in CRC.

5-Fluorouracil Induced Hypertriglyceridemia During the Colorectal Cancer Treatment in a Patient With Multifactorial Chylomicronemia Syndrome: A Case Report

PURPOSE

The case of a 47-year-old female patient who underwent sigmoidectomy for metastatic colorectal cancer is reported. Treatment with capecitabine and 5-fluorouracil induced severe hypertriglyceridemia repeatedly.

METHODS

Based on laboratory tests and clinical evaluations, treatment was suggested by specialists.

FINDINGS

After treatment with capecitabine, the patient's triglycerides increased from 19.7 mmol/L to 42 mmol/L. It was proposed that the patient had multifactorial chylomicronemia syndrome triggered by secondary factors. Statins, fenofibrate, ezetimib, and metformin were added to the therapy. After metastases appeared, FOLFIRI (leucovorin calcium [folinic acid], 5-fluorouracil, and irinotecan hydrochloride) chemotherapy and biological treatment (cetuximab) followed and triglycerides increased to 55.3 mmol/L.

IMPLICATIONS

Monitoring triglyceride levels before and during therapy is suggested.