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Master's Dissertation
DOI
10.11606/D.17.2016.tde-08122015-164514
Document
Author
Full name
Tássia Aparecida Martins de Carvalho
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2015
Supervisor
Committee
Mello, Luane Marques (President)
Magalhaes, Fernanda Oliveira
Peria, Fernanda Maris
Title in Portuguese
Uso de metformina e a ocorrência de neoplasias em pacientes com Diabetes Mellitus pré-existente
Keywords in Portuguese
câncer
diabetes mellitus
metformina
Abstract in Portuguese
Um crescente número de estudos tem associado diabetes mellitus a risco aumentado para o desenvolvimento de câncer e ao aumento da mortalidade específica por câncer. Por outro lado, diversos estudos sugerem que a metformina pode estar associada à redução do risco de desenvolvimento e de morte relacionada ao câncer em pacientes com diabetes mellitus. Diversas evidências disponíveis na literatura sugerem o papel da metformina como uma droga antineoplásica. No entanto, o mecanismo envolvido neste efeito benéfico da metformina não é totalmente compreendido. Apesar das evidências, alguns autores discordam quanto ao papel da metformina na redução do risco de câncer em pacientes com diabetes mellitus. Assim, o presente estudo objetivou identificar o perfil dos pacientes com diabetes mellitus que desenvolveram neoplasias e verificar a relação entre o uso de metformina e a presença de neoplasias em indivíduos com diagnóstico prévio de diabetes mellitus. Trata-se de um estudo caso-controle, onde foram selecionados 510 prontuários de pacientes de ambos os sexos, com idade acima de 35 anos que passaram por internações no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, no período de 2002 a 2012, com diagnóstico de diabetes mellitus, classificadas segundo CID-10 com os códigos de E10 a E14, e pacientes com diagnóstico de neoplasias malignas classificadas nos seguintes códigos do CID-10: C00-C75; C76 a C80; C97; D00 a D09; D37 a D48. Foram formados dois grupos na proporção de 1:2, sendo o grupo de casos com diagnóstico de diabetes mellitus e Neoplasias (170 prontuários) e o grupo controle com diagnóstico de diabetes mellitus sem neoplasias (340 prontuários). Os prontuários foram analisados quanto às variáveis sociodemográficas e clínico-epidemiológicas. Os resultados do presente estudo mostraram medianas de idade significativamente maiores no grupo de casos (portadores de diabetes mellitus e neoplasia), assim como maior ocorrência de óbitos, tabagismo e uso de metformina prévio. O tempo de uso de metformina, a dose de insulina NPH utilizada nos últimos 12 meses e a presença de obesidade foram significativamente maiores entre os pacientes com diabetes mellitus sem neoplasia (grupo controle). O estudo sugere a necessidade de mais estudos para avaliar o papel da metformina na ocorrência de neoplasias em pacientes com diabetes mellitus pré-existente
Title in English
Use of Metformin and Neoplasms Occurred in Patients with Diabetes Mellitus Pre-Existing
Keywords in English
cancer
diabetes mellitus
metformin
Abstract in English
An increasing number of studies have associated diabetes mellitus with an increased risk for the development of cancer and increased specific cancer mortality. Furthermore, several studies suggest that metformin may be associated with reduced risk for developing cancer and cancer-related death in patients with diabetes mellitus. Several available evidence in the literature suggests the role of metformin as an anticancer drug. However, the mechanism involved in this beneficial effect of metformin is not fully understood. Despite the evidence, there are conflicting data on the role of metformin in reducing the risk of cancer in patients with diabetes mellitus. Thus, this study aimed to identify the profile of patients with diabetes mellitus who developed cancer and to investigate the relationship between the use of metformin and the occurrence of malignancies in patients with a previous diagnosis of diabetes mellitus. This is a case-control study where we selected 510 medical records of patients of both sexes, aged 35 years and over who have undergone hospitalization at the Hospital of Ribeirão Preto Medical School, University of São Paulo, in the 2002-2012 period, with diagnosis of diabetes mellitus, categorized by ICD-10 codes E10 to E14, and patients with diagnosis of malignancies classified by the following ICD-10 codes: C00-C75; C76 to C80; C97; D00 to D09; D37 to D48. Two groups were formed, at the proportion 1: 2, one composed by patients with diabetes mellitus and neoplasms, considered the group of cases (170 records) and another group by patients with diabetes mellitus, considered the control group (340 records). The medical records were analyzed regarding to sociodemographic and clinical-epidemiological variables. The results of this study showed significantly higher median age in the case group (patients with diabetes mellitus and cancer), as well as the occurrence of deaths, smoking, previous use of metformin. Length of metformin use, NPH insulin dose used in the last 12 months and the presence of obesity were significantly higher among patients with diabetes mellitus without cancer (controls). The study suggests the necessity of other studies to clarify the real role of metformin in the occurrence of tumors in patients with pre-existing diabetes mellitus
 
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Publishing Date
2016-03-11
 
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