以健保資料庫與癌症登記檔分析糖尿病患者使用胰島素治療罹患癌症之風險

Using NHIRD and Taiwan Cancer Registry to Analyze the Relationship Between Insulin and the Risk of Cancer with Diabetes

王詩婷(Shih-Ting Wang)

指導教授 ： 邱泓文

臺北醫學大學/醫學科技學院/醫學資訊研究所/碩士(2016年)

摘要

動機：糖尿病與癌症有高度的相關性。目前研究指出，糖尿病患者中使用胰島素治療者會增加其罹癌的風險。

目的： (1)評估糖尿病患使用胰島素治療者使用在罹癌風險上是否大於沒有使用胰島素治療者。(2)評估使用胰島素時間大於兩年者在罹癌風險上是否高於使用時間小於兩年者。

方法：藉由全民健康保險研究資料庫找出糖尿病患使用胰島素治療並且罹患癌症之研究對象。研究將分為實驗組以及對照組，實驗組為使用胰島素且罹癌之病患，對照組為沒有使用胰島素但罹癌之病患，並利用卡方檢定算出其因素與癌症之間關聯分析之結果。

結果：無法證實在追蹤時間五年內，使用胰島素治療的糖尿病患相較於沒有使用胰島素治療的病患有較高的罹癌風險。在追蹤時間五年內，使用胰島素治療時間大於兩年者者與胰島素治療時間小於兩年者相比，沒有較高的罹癌風險。

關鍵字

全民健保資料庫 ； 糖尿病 ； 胰島素 ； 癌症 ； 卡方檢定 ； 邏輯斯迴歸分析 ； 存活分析

並列摘要

Background: Recent studies have suggested that some insulin analogs could be associated with an increased risk of cancer. The aim of this dissertation is to examine whether patients with diabetes mellitus (DM) using insulin have a higher risk of cancer in comparison to patients using other types of therapy.

Objectives: This dissertation first will estimate the risk of cancer on diabetes with insulin therapy and non-insulin therapy. Secondly, estimate the risk of cancer on insulin using more than 2 years, and under 2 years.

Methodology: This dissertation used the National Health Insurance Research Database (NHIRD) that covers the majority of Taiwan population with diagnosed diabetes, and examined patients with diabetes who were exposed to any insulin therapy between 1 January 2001 and 31 December 2003. This dissertation defined two cohorts, patient with insulin therapy as the experimental samples, and non-insulin therapy as control samples. Record from these cohorts were linked to cancer registry data up to the end of 2009. Then use Chi-square test to analyze their risk of cancer.

Results: Within five years, the risk of cancer associated with the use of insulin is still not well defined. Also, long term (over 2 years) use of insulin does not appear to increase the risk of cancer.

並列關鍵字

NHIRD ； Diabetes Mellitus(DM) ； Insulin ； Cancer ； Chi-square test ； Logistic Regression ； Cox Regression

參考文獻

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