Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 16, 2024; 12(20): 4206-4216
Published online Jul 16, 2024. doi: 10.12998/wjcc.v12.i20.4206
Metformin administration in prevention of colorectal polyps in type 2 diabetes mellitus patients
Xiao-Qing Wu, Li-Hua Deng, Qian Xue, Xia Li, Meng-Han Li, Jing-Tong Wang
Xiao-Qing Wu, Li-Hua Deng, Qian Xue, Xia Li, Meng-Han Li, Jing-Tong Wang, Department of Geriatrics, Peking University People's Hospital, Beijing 100044, China
Author contributions: Wu XQ contributed as the leader of project, development of research plan, sample collection, statistical analysis and writing the paper; Deng LH contributed to the data analysis review; Xue Q contributed the part of discussion and critical review; Li X and Li MH contributed to the critical review; Wang JT commented on previous versions of the manuscript and reviewed the final document; All authors perused and approved the final draft of this manuscript.
Supported by The International Institute of Population Health, Peking University Health Science Center, No. JKCJ202102; and The National Key Clinical Specialty Construction Projects, No. 2199000764.
Institutional review board statement: This study was reviewed and approved by the Ethics Review Committee of Peking University People's Hospital (Approval No. 2021B012-00).
Informed consent statement: All study participants provide informed written consent prior to study registration.
Conflict-of-interest statement: The authors declare having no conflicts of interest. The entities that funded this study were not associated in any way with the study design; data collection, analysis, and interpretation; or manuscript preparation; and did not enforce any restrictions related to the publication of this work.
Data sharing statement: The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jing-Tong Wang, Doctor, Deputy Director, Department of Geriatrics, Peking University People's Hospital, No. 11 Xizhimen South Street, Xicheng District, Beijing 100044, China. wangjingtong11@163.com
Received: March 10, 2024
Revised: May 7, 2024
Accepted: May 29, 2024
Published online: July 16, 2024
Processing time: 112 Days and 15.7 Hours
Abstract
BACKGROUND

Colorectal polyps are frequently observed in patients with type 2 diabetes mellitus (DM), posing a significant risk for colorectal cancer. Metformin, a widely prescribed biguanidine drug for type 2 DM, has been suggested to have potential chemoprophylactic effects against various cancers.

AIM

To explore the correlation between colorectal polyps and metformin use in type 2 DM patients.

METHODS

Type 2 DM patients were categorized into polyp and non-polyp groups. Following this, all patients were categorized into the type 2 DM-metformin, type 2 DM-non-metformin, and non-type 2 DM groups. Based on the baseline colonoscopy results, we performed pairwise comparisons of the incidence of colorectal polyps among the three groups. Additionally, we analyzed the relationship between colorectal polyps and the duration of metformin use and between the size and number of polyps and metformin use. Simultaneously, we focused on the specific pathological types of polyps and analyzed their relationship with metformin use. Finally, we compared the incidence of polyps between metformin and non-metformin groups according to the interval colonoscopy results.

RESULTS

The rate of metformin use in patients with colorectal polyps was 0.502 times that of patients without colorectal polyps [odds ratio (OR) = 0.502, 95% confidence interval (CI): 0.365-0.689; P < 0.001]. The incidence of colorectal polyps did not differ significantly between the type 2 DM-metformin and non-type 2 DM groups (P > 0.05). Furthermore, the correlations between the duration of metformin use and the incidence of colorectal polyps and between the size and number of polyps and metformin use were not statistically significant (P > 0.05). Metformin use did not affect the incidence of colorectal polyps during interval colonoscopy (P > 0.05).

CONCLUSION

Metformin use and colorectal polyp incidence in type 2 DM patients showed a negative correlation, independent of the hypoglycemic effect of metformin.

Keywords: Colorectal cancer; Colorectal polyps; Biguanidine drug; Diabetes mellitus; Metformin

Core Tip: Studies have shown that oral metformin can safely and effectively reduce the incidence of colorectal adenomas. There is also literature suggesting that metformin has potential efficacy in preventing the development of colonic polyps in patients with acromegaly.