Skip to main content

Advertisement

SpringerLink
Log in

The effect of metformin on the recurrence of colorectal adenoma in diabetic patients with previous colorectal adenoma

  • Short Communication
  • Published:
International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Existing studies suggest that metformin lowers the risk and mortality of colorectal cancer. However, the effect of metformin on the suppression and prevention of colorectal adenomas is not clear. The aim of this study was to evaluate the effect of metformin on the recurrence of colorectal adenoma in diabetic patients with previous colorectal adenoma.

Methods

Among 423 diabetic patients who underwent surveillance colonoscopy after resection of colorectal adenoma between 2005 and 2011, 257 patients were retrospectively reviewed. The patients were divided into two groups: one group comprising 106 patients who took metformin and another group comprising 151 patients who did not take metformin. The clinical characteristics, colorectal adenoma recurrence, and valuable factors for adenoma recurrence were analyzed.

Results

At surveillance colonoscopy after colonoscopic polypectomy for adenoma, 38 patients (35.8%) exhibited colorectal adenoma among 106 patients who took metformin, compared with 85 patients (56.3%) with colorectal adenoma among 151 patients who did not take metformin (odds ratio 0.434, 95% confidence interval 0.260–0.723, P = 0.001). Multivariate Cox analysis showed that metformin was associated with decreased recurrence of colorectal adenoma (hazard ratio 0.572, 95% confidence interval 0.385–0.852, P = 0.006) in diabetic patients with previous colorectal adenoma. The cumulative probability of colorectal adenoma recurrence was significantly lower in the metformin group than in the non-metformin group (P = 0.001).

Conclusion

Metformin use in diabetic patients with previous colorectal adenoma is associated with a lower risk of colorectal adenoma recurrence.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  1. Siegel RL, Miller KD, Jemal A (2016) Cancer statistics, 2016. CA Cancer J Clin 66(1):7–30

    Article  PubMed  Google Scholar 

  2. Fearon ER, Vogelstein B (1990) A genetic model for colorectal tumorigenesis. Cell 61(5):759–767

    Article  CAS  PubMed  Google Scholar 

  3. Cuzick J, Otto F, Baron JA et al (2009) Aspirin and non-steroidal anti-inflammatory drugs for cancer prevention: an international consensus statement. Lancet Oncol 10(5):501–507

    Article  CAS  PubMed  Google Scholar 

  4. Arber N, Eagle CJ, Spicak J et al (2006) Celecoxib for the prevention of colorectal adenomatous polyps. N Engl J Med 355(9):885–895

    Article  CAS  PubMed  Google Scholar 

  5. Shaw RJ, Lamia KA, Vasquez D, Koo SH, Bardeesy N, Depinho RA, Montminy M, Cantley LC (2005) The kinase LKB1 mediates glucose homeostasis in liver and therapeutic effects of metformin. Science 310(5754):1642–1646

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Hosono K, Endo H, Takahashi H et al (2010) Metformin suppresses azoxymethane-induced colorectal aberrant crypt foci by activating AMP-activated protein kinase. Mol Carcinog 49(7):662–671

    Article  CAS  PubMed  Google Scholar 

  7. Mei ZB, Zhang ZJ, Liu CY, Liu Y, Cui A, Liang ZL, Wang GH, Cui L (2014) Survival benefits of metformin for colorectal cancer patients with diabetes: a systematic review and meta-analysis. PLoS One 9(3):e91818

    Article  PubMed  PubMed Central  Google Scholar 

  8. Kim YH, Noh R, Cho SY, Park SJ, Jeon SM, Shin HD, Kim SB, Shin JE (2015) Inhibitory effect of metformin therapy on the incidence of colorectal advanced adenomas in patients with diabetes. Intest Res 13(2):145–152

    Article  PubMed  PubMed Central  Google Scholar 

  9. Guraya SY (2015) Association of type 2 diabetes mellitus and the risk of colorectal cancer: a meta-analysis and systematic review. World J Gastroenterol 21(19):6026–6031

    CAS  PubMed  PubMed Central  Google Scholar 

  10. Lee JH, Jeon SM, Hong SP, Cheon JH, Kim TI, Kim WH (2012) Metformin use is associated with a decreased incidence of colorectal adenomas in diabetic patients with previous colorectal cancer. Dig Liver Dis 44(12):1042–1047

    Article  CAS  PubMed  Google Scholar 

  11. Takahashi H, Hosono K, Uchiyama T, Sugiyama M, Sakai E, Endo H, Maeda S, Schaefer KL, Nakagama H, Nakajima A (2010) PPARgamma ligand as a promising candidate for colorectal cancer chemoprevention: a pilot study. PPAR Res 2010.

  12. Higurashi T, Hosono K, Takahashi H et al (2016) Metformin for chemoprevention of metachronous colorectal adenoma or polyps in post-polypectomy patients without diabetes: a multicentre double-blind, placebo-controlled, randomised phase 3 trial. Lancet Oncol 17(4):475–483

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, 50, Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea

    Min Seok Han, Hyun Jung Lee, Soo Jung Park, Sung Pil Hong, Jae Hee Cheon, Won Ho Kim & Tae Il Kim

  2. Cancer Prevention Center, Severance Hospital, Yonsei University Health System, Seoul, South Korea

    Tae Il Kim

Authors
  1. Min Seok Han
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hyun Jung Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Soo Jung Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sung Pil Hong
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jae Hee Cheon
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Won Ho Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Tae Il Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tae Il Kim.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Han, M.S., Lee, H.J., Park, S.J. et al. The effect of metformin on the recurrence of colorectal adenoma in diabetic patients with previous colorectal adenoma. Int J Colorectal Dis 32, 1223–1226 (2017). https://doi.org/10.1007/s00384-017-2782-z

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00384-017-2782-z

Keywords

Search

Navigation