Statin use as a moderator of metformin effect on risk for prostate cancer among type 2 diabetic patients

Donna M Lehman, Carlos Lorenzo, Javier Hernandez, Chen-pin Wang

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

OBJECTIVE - Metformin and statins have shown promise for cancer prevention. This study assessed whether the effect of metformin on prostate cancer (PCa) incidence varied by statin use among type 2 diabetic patients. RESEARCH DESIGN AND METHODS - The study cohort consisted of 5,042 type 2 diabetic male patients seen in the Veteran Administration Health Care System who were without prior cancer and were prescribed with metformin or sulfonylurea as the exclusive hypoglycemic medication between fiscal years 1999 and 2005. Cox proportional hazards analyses were conducted to assess the differential hazard ratio (HR) of PCa due to metformin by statin use versus sulfonylurea use, where propensity scores of metformin and statin use were adjusted to account for imbalances in baseline covariates across medication groups. RESULTS - Mean follow-up was ∼5 years, and 7.5% had a PCa diagnosis. Statin use modified the effect of metformin on PCa incidence (P < 0.0001). Metformin was associated with a significantly reduced PCa incidence among patients on statins (HR 0.69 [95% CI 0.50-0.92]; 17 cases/533 metformin users vs. 135 cases/2,404 sulfonylureas users) and an increased PCa incidence among patients not on statins (HR 2.15 [1.83-2.52]; 22 cases/175 metformin users vs. 186 cases/1,930 sulfonylureas users). The HR of PCa incidence for those taking metformin and statins versus those taking neither medication was 0.32 (0.25-0.42). CONCLUSIONS - Among men with type 2 diabetes, PCa incidence among metformin users varied by their statin use. The potential beneficial influence on PCa by combination use of metformin and statin may be due to synergistic effects.

Original languageEnglish (US)
Pages (from-to)1002-1007
Number of pages6
JournalDiabetes Care
Volume35
Issue number5
DOIs
StatePublished - May 2012

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Metformin
Prostatic Neoplasms
Incidence
Veterans Health
Propensity Score
United States Department of Veterans Affairs
Hypoglycemic Agents
Type 2 Diabetes Mellitus
Neoplasms
Cohort Studies
Research Design

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

Statin use as a moderator of metformin effect on risk for prostate cancer among type 2 diabetic patients. / Lehman, Donna M; Lorenzo, Carlos; Hernandez, Javier; Wang, Chen-pin.

In: Diabetes Care, Vol. 35, No. 5, 05.2012, p. 1002-1007.

Research output: Contribution to journalArticle

Lehman, Donna M ; Lorenzo, Carlos ; Hernandez, Javier ; Wang, Chen-pin. / Statin use as a moderator of metformin effect on risk for prostate cancer among type 2 diabetic patients. In: Diabetes Care. 2012 ; Vol. 35, No. 5. pp. 1002-1007.
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