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KMID : 0988920140120020139
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Intestinal Research
2014 Volume.12 No. 2 p.139 ~ p.145
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Does Metformin Affect The Incidence of Colonic Polyps and Adenomas in Patients with Type 2 Diabetes Mellitus?
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Cho Youn-Hee
Ko Bong-Min
Kim Shin-Hee
Myung Yu-Sik
Choi Jong-Hyo
Han Jae-Pil
Hong Su-Jin
Jeon Seong-Ran
Kim Hyun-Gun
Kim Jin-Oh
Lee Moon-Sung
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Abstract
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Background/Aims: Colorectal cancer (CRC) develops from colonic adenomas. Type 2 diabetes mellitus (DM) is associatedwith a higher risk of CRC and metformin decreases CRC risk. However, it is not certain if metformin affects the developmentof colorectal polyps and adenomas. This study aimed to elucidate if metforminaffects the incidence of colonic polyps and adenomasin patients with type 2 DM.
Methods: Of 12,186 patients with type 2 DM, 3,775 underwent colonoscopy between May2001 and March 2013. This study enrolled 3,105 of these patients, and divided them in two groups: 912 patients with metforminuse and 2,193 patients without metformin use. Patient clinical characteristics, polyp and adenoma detection rate in the twogroups were analyzed retrospectively.
Results: The Colorectal polyp detection rate was lower in the metformin group than inthe non-meformin group (39.4% vs. 62.4%, P <0.01). Colorectal adenoma detection rate was significantly lower in the metformingroup than in the non-metformin group (15.2% vs. 20.5%, P <0.01). Fewer advanced adenomas were detected in the metformingroup than in the non-metformin group (12.2% vs. 22%, P <0.01). Multivariate analysis identified age, sex, Body mass index andmetformin use as factors associated with polyp incidence, whereas only metforminwas independently associated with decreasedadenoma incidence (Odd ratio=0.738, 95% CI=0.554?0.983, P =0.03).
Conclusions: In patients with type 2 DM, metforminreduced the incidence of adenomas that may transform into CRC. Therefore, metformin may be useful for the preventionof CRC in patients with type 2 DM. (Intest Res 2014;12:139-145)
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KEYWORD
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Colon adenoma, Adenoma detection rate, Polyp detection rate, Metformin, Diabetes mellitus, type 2
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