Does metformin reduce the risk of cancer in obesity and diabetes? A systematic review and meta‐analysis
Aim To evaluate the effect of metformin on cancer incidence in subjects with overweight/obesity and/or prediabetes/diabetes. Materials and Methods We searched MEDLINE, Embase and CENTRAL for randomized controlled trials (RCTs) in adults with overweight/obesity and/or prediabetes/diabetes that compar...
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| Veröffentlicht in: | Diabetes, obesity & metabolism obesity & metabolism, 2024-05, Vol.26 (5), p.1929-1940 |
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| container_issue | 5 |
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| container_title | Diabetes, obesity & metabolism |
| container_volume | 26 |
| creator | Mesquita, Leonardo A. Spiazzi, Bernardo F. Piccoli, Giovana F. Nogara, Daniela A. Natividade, Gabriella R. Garbin, Henrique I. Wayerbacher, Laura F. Wiercinski, Vanessa M. Baggio, Viviane A. Zingano, Carolina P. Schwartsmann, Gilberto Lopes, Gilberto Petrie, John R. Colpani, Verônica Gerchman, Fernando |
| description | Aim
To evaluate the effect of metformin on cancer incidence in subjects with overweight/obesity and/or prediabetes/diabetes.
Materials and Methods
We searched MEDLINE, Embase and CENTRAL for randomized controlled trials (RCTs) in adults with overweight/obesity and/or prediabetes/diabetes that compared metformin to other interventions for ≥24 weeks. Independent reviewers selected and extracted data including population and intervention characteristics and new diagnoses of cancer. We used the RoB 2.0 risk‐of‐bias tool and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework to assess risk of bias and certainty of evidence.
Results
From 14 895 records after removal of duplicates, 27 trials were included, providing a total of 10 717 subjects in the metformin group and 10 003 in the control group, with 170 and 208 new cases of cancer, respectively. Using a random‐effects model, the relative risk was 1.07 (95% confidence interval 0.87–1.31), with similar results in subgroup analyses by study duration or effect of control intervention on weight. Risk of bias in most studies was low, and no evidence of publication bias was found. Trial sequential analysis provided evidence that the cumulative sample size was large enough to exclude a significant effect of metformin on cancer incidence.
Conclusions
Metformin did not reduce cancer incidence in RCTs involving subjects with overweight/obesity and/or prediabetes/diabetes. |
| doi_str_mv | 10.1111/dom.15509 |
| format | Article |
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To evaluate the effect of metformin on cancer incidence in subjects with overweight/obesity and/or prediabetes/diabetes.
Materials and Methods
We searched MEDLINE, Embase and CENTRAL for randomized controlled trials (RCTs) in adults with overweight/obesity and/or prediabetes/diabetes that compared metformin to other interventions for ≥24 weeks. Independent reviewers selected and extracted data including population and intervention characteristics and new diagnoses of cancer. We used the RoB 2.0 risk‐of‐bias tool and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework to assess risk of bias and certainty of evidence.
Results
From 14 895 records after removal of duplicates, 27 trials were included, providing a total of 10 717 subjects in the metformin group and 10 003 in the control group, with 170 and 208 new cases of cancer, respectively. Using a random‐effects model, the relative risk was 1.07 (95% confidence interval 0.87–1.31), with similar results in subgroup analyses by study duration or effect of control intervention on weight. Risk of bias in most studies was low, and no evidence of publication bias was found. Trial sequential analysis provided evidence that the cumulative sample size was large enough to exclude a significant effect of metformin on cancer incidence.
Conclusions
Metformin did not reduce cancer incidence in RCTs involving subjects with overweight/obesity and/or prediabetes/diabetes.</description><identifier>ISSN: 1462-8902</identifier><identifier>ISSN: 1463-1326</identifier><identifier>EISSN: 1463-1326</identifier><identifier>DOI: 10.1111/dom.15509</identifier><identifier>PMID: 38389430</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Antidiabetics ; Body weight ; Cancer ; Diabetes ; Diabetes mellitus ; Meta-analysis ; Metformin ; Obesity ; Overweight</subject><ispartof>Diabetes, obesity & metabolism, 2024-05, Vol.26 (5), p.1929-1940</ispartof><rights>2024 John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3539-ca056d24f3118240a826bb5a9a997f89be4c6f7747e2de5fcd5fc666a59e59423</citedby><cites>FETCH-LOGICAL-c3539-ca056d24f3118240a826bb5a9a997f89be4c6f7747e2de5fcd5fc666a59e59423</cites><orcidid>0000-0002-7908-4213 ; 0000-0003-3281-4554 ; 0000-0001-5873-9498 ; 0000-0001-9884-0654 ; 0000-0002-6373-0057 ; 0000-0001-5950-632X ; 0000-0001-6392-3054 ; 0000-0002-7850-1644 ; 0000-0002-2811-3619 ; 0000-0002-1151-9903 ; 0000-0001-9170-1950 ; 0000-0002-4894-9819</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fdom.15509$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fdom.15509$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38389430$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mesquita, Leonardo A.</creatorcontrib><creatorcontrib>Spiazzi, Bernardo F.</creatorcontrib><creatorcontrib>Piccoli, Giovana F.</creatorcontrib><creatorcontrib>Nogara, Daniela A.</creatorcontrib><creatorcontrib>Natividade, Gabriella R.</creatorcontrib><creatorcontrib>Garbin, Henrique I.</creatorcontrib><creatorcontrib>Wayerbacher, Laura F.</creatorcontrib><creatorcontrib>Wiercinski, Vanessa M.</creatorcontrib><creatorcontrib>Baggio, Viviane A.</creatorcontrib><creatorcontrib>Zingano, Carolina P.</creatorcontrib><creatorcontrib>Schwartsmann, Gilberto</creatorcontrib><creatorcontrib>Lopes, Gilberto</creatorcontrib><creatorcontrib>Petrie, John R.</creatorcontrib><creatorcontrib>Colpani, Verônica</creatorcontrib><creatorcontrib>Gerchman, Fernando</creatorcontrib><title>Does metformin reduce the risk of cancer in obesity and diabetes? A systematic review and meta‐analysis</title><title>Diabetes, obesity & metabolism</title><addtitle>Diabetes Obes Metab</addtitle><description>Aim
To evaluate the effect of metformin on cancer incidence in subjects with overweight/obesity and/or prediabetes/diabetes.
Materials and Methods
We searched MEDLINE, Embase and CENTRAL for randomized controlled trials (RCTs) in adults with overweight/obesity and/or prediabetes/diabetes that compared metformin to other interventions for ≥24 weeks. Independent reviewers selected and extracted data including population and intervention characteristics and new diagnoses of cancer. We used the RoB 2.0 risk‐of‐bias tool and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework to assess risk of bias and certainty of evidence.
Results
From 14 895 records after removal of duplicates, 27 trials were included, providing a total of 10 717 subjects in the metformin group and 10 003 in the control group, with 170 and 208 new cases of cancer, respectively. Using a random‐effects model, the relative risk was 1.07 (95% confidence interval 0.87–1.31), with similar results in subgroup analyses by study duration or effect of control intervention on weight. Risk of bias in most studies was low, and no evidence of publication bias was found. Trial sequential analysis provided evidence that the cumulative sample size was large enough to exclude a significant effect of metformin on cancer incidence.
Conclusions
Metformin did not reduce cancer incidence in RCTs involving subjects with overweight/obesity and/or prediabetes/diabetes.</description><subject>Antidiabetics</subject><subject>Body weight</subject><subject>Cancer</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Meta-analysis</subject><subject>Metformin</subject><subject>Obesity</subject><subject>Overweight</subject><issn>1462-8902</issn><issn>1463-1326</issn><issn>1463-1326</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp1kMtO3DAUhq2qqNBpF30BZKkbugj4lotXaASlRQLNhq4txzlRTZMYfBJQdn0EnpEnwcwMLJA4knUs-fOnXz8h3zg75GmOmtAf8jxn-gPZ46qQGZei-Li-i6zSTOySz4jXjDElq_IT2ZWVrLSSbI_40wBIexjbEHs_0AjN5ICOf4FGj_9oaKmzg4NI02OoAf04Uzs0tPG2hhHwmC4pzjhCb0fv0v87D_drIknt4_8HO9huRo9fyE5rO4Sv270gf85-Xp38zi5Wv85PlheZk7nUmbMsLxqhWsl5JRSzlSjqOrfaal22la5BuaItS1WCaCBvXZNOURQ215BrJeSCHGy8NzHcToCj6T066Do7QJjQCC0FE8ksE_r9DXodppjyopFMKi55lTItyI8N5WJAjNCam-h7G2fDmXnu36T-zbr_xO5vjVPdQ_NKvhSegKMNcO87mN83mdPV5Ub5BCGQj4Y</recordid><startdate>202405</startdate><enddate>202405</enddate><creator>Mesquita, Leonardo A.</creator><creator>Spiazzi, Bernardo F.</creator><creator>Piccoli, Giovana F.</creator><creator>Nogara, Daniela A.</creator><creator>Natividade, Gabriella R.</creator><creator>Garbin, Henrique I.</creator><creator>Wayerbacher, Laura F.</creator><creator>Wiercinski, Vanessa M.</creator><creator>Baggio, Viviane A.</creator><creator>Zingano, Carolina P.</creator><creator>Schwartsmann, Gilberto</creator><creator>Lopes, Gilberto</creator><creator>Petrie, John R.</creator><creator>Colpani, Verônica</creator><creator>Gerchman, Fernando</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7908-4213</orcidid><orcidid>https://orcid.org/0000-0003-3281-4554</orcidid><orcidid>https://orcid.org/0000-0001-5873-9498</orcidid><orcidid>https://orcid.org/0000-0001-9884-0654</orcidid><orcidid>https://orcid.org/0000-0002-6373-0057</orcidid><orcidid>https://orcid.org/0000-0001-5950-632X</orcidid><orcidid>https://orcid.org/0000-0001-6392-3054</orcidid><orcidid>https://orcid.org/0000-0002-7850-1644</orcidid><orcidid>https://orcid.org/0000-0002-2811-3619</orcidid><orcidid>https://orcid.org/0000-0002-1151-9903</orcidid><orcidid>https://orcid.org/0000-0001-9170-1950</orcidid><orcidid>https://orcid.org/0000-0002-4894-9819</orcidid></search><sort><creationdate>202405</creationdate><title>Does metformin reduce the risk of cancer in obesity and diabetes? A systematic review and meta‐analysis</title><author>Mesquita, Leonardo A. ; Spiazzi, Bernardo F. ; Piccoli, Giovana F. ; Nogara, Daniela A. ; Natividade, Gabriella R. ; Garbin, Henrique I. ; Wayerbacher, Laura F. ; Wiercinski, Vanessa M. ; Baggio, Viviane A. ; Zingano, Carolina P. ; Schwartsmann, Gilberto ; Lopes, Gilberto ; Petrie, John R. ; Colpani, Verônica ; Gerchman, Fernando</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3539-ca056d24f3118240a826bb5a9a997f89be4c6f7747e2de5fcd5fc666a59e59423</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Antidiabetics</topic><topic>Body weight</topic><topic>Cancer</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Meta-analysis</topic><topic>Metformin</topic><topic>Obesity</topic><topic>Overweight</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mesquita, Leonardo A.</creatorcontrib><creatorcontrib>Spiazzi, Bernardo F.</creatorcontrib><creatorcontrib>Piccoli, Giovana F.</creatorcontrib><creatorcontrib>Nogara, Daniela A.</creatorcontrib><creatorcontrib>Natividade, Gabriella R.</creatorcontrib><creatorcontrib>Garbin, Henrique I.</creatorcontrib><creatorcontrib>Wayerbacher, Laura F.</creatorcontrib><creatorcontrib>Wiercinski, Vanessa M.</creatorcontrib><creatorcontrib>Baggio, Viviane A.</creatorcontrib><creatorcontrib>Zingano, Carolina P.</creatorcontrib><creatorcontrib>Schwartsmann, Gilberto</creatorcontrib><creatorcontrib>Lopes, Gilberto</creatorcontrib><creatorcontrib>Petrie, John R.</creatorcontrib><creatorcontrib>Colpani, Verônica</creatorcontrib><creatorcontrib>Gerchman, Fernando</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetes, obesity & metabolism</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mesquita, Leonardo A.</au><au>Spiazzi, Bernardo F.</au><au>Piccoli, Giovana F.</au><au>Nogara, Daniela A.</au><au>Natividade, Gabriella R.</au><au>Garbin, Henrique I.</au><au>Wayerbacher, Laura F.</au><au>Wiercinski, Vanessa M.</au><au>Baggio, Viviane A.</au><au>Zingano, Carolina P.</au><au>Schwartsmann, Gilberto</au><au>Lopes, Gilberto</au><au>Petrie, John R.</au><au>Colpani, Verônica</au><au>Gerchman, Fernando</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Does metformin reduce the risk of cancer in obesity and diabetes? A systematic review and meta‐analysis</atitle><jtitle>Diabetes, obesity & metabolism</jtitle><addtitle>Diabetes Obes Metab</addtitle><date>2024-05</date><risdate>2024</risdate><volume>26</volume><issue>5</issue><spage>1929</spage><epage>1940</epage><pages>1929-1940</pages><issn>1462-8902</issn><issn>1463-1326</issn><eissn>1463-1326</eissn><abstract>Aim
To evaluate the effect of metformin on cancer incidence in subjects with overweight/obesity and/or prediabetes/diabetes.
Materials and Methods
We searched MEDLINE, Embase and CENTRAL for randomized controlled trials (RCTs) in adults with overweight/obesity and/or prediabetes/diabetes that compared metformin to other interventions for ≥24 weeks. Independent reviewers selected and extracted data including population and intervention characteristics and new diagnoses of cancer. We used the RoB 2.0 risk‐of‐bias tool and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework to assess risk of bias and certainty of evidence.
Results
From 14 895 records after removal of duplicates, 27 trials were included, providing a total of 10 717 subjects in the metformin group and 10 003 in the control group, with 170 and 208 new cases of cancer, respectively. Using a random‐effects model, the relative risk was 1.07 (95% confidence interval 0.87–1.31), with similar results in subgroup analyses by study duration or effect of control intervention on weight. Risk of bias in most studies was low, and no evidence of publication bias was found. Trial sequential analysis provided evidence that the cumulative sample size was large enough to exclude a significant effect of metformin on cancer incidence.
Conclusions
Metformin did not reduce cancer incidence in RCTs involving subjects with overweight/obesity and/or prediabetes/diabetes.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>38389430</pmid><doi>10.1111/dom.15509</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-7908-4213</orcidid><orcidid>https://orcid.org/0000-0003-3281-4554</orcidid><orcidid>https://orcid.org/0000-0001-5873-9498</orcidid><orcidid>https://orcid.org/0000-0001-9884-0654</orcidid><orcidid>https://orcid.org/0000-0002-6373-0057</orcidid><orcidid>https://orcid.org/0000-0001-5950-632X</orcidid><orcidid>https://orcid.org/0000-0001-6392-3054</orcidid><orcidid>https://orcid.org/0000-0002-7850-1644</orcidid><orcidid>https://orcid.org/0000-0002-2811-3619</orcidid><orcidid>https://orcid.org/0000-0002-1151-9903</orcidid><orcidid>https://orcid.org/0000-0001-9170-1950</orcidid><orcidid>https://orcid.org/0000-0002-4894-9819</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1462-8902 |
| ispartof | Diabetes, obesity & metabolism, 2024-05, Vol.26 (5), p.1929-1940 |
| issn | 1462-8902 1463-1326 1463-1326 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2932022403 |
| source | Wiley Online Library Journals Frontfile Complete |
| subjects | Antidiabetics Body weight Cancer Diabetes Diabetes mellitus Meta-analysis Metformin Obesity Overweight |
| title | Does metformin reduce the risk of cancer in obesity and diabetes? A systematic review and meta‐analysis |
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