PMC9120816_01
Subgroup analysis of high cDDD group for the association between DPP4is exposure and risk of colorectal cancer among patients with T2DM. *Adjustment for covariates listed in 
Table 1
, including age, socioeconomic status, modified CCI, previous and coexisting medical conditions (cholangitis, cholelithiasis, cholecystitis, cirrhosis of liver, alcoholic liver disease, chronic nonalcoholic liver disease, hepatitis B, hepatitis C, inflammatory bowel disease, adenomatous polyposis, peptic ulcer, GERD, cardiovascular disease, hyperlipidemia, and hypertension), prescribed medications before the index date of cancer diagnosis (ACEIs/ARBs, beta-2 blockers, diuretics, CCBs, antiplatelet drugs, statin, NSAIDs, and steroids) and other OADs (metformin, thiazolidinedione, sulfonylureas, alpha-glucosidase inhibitor, and insulin). ACEIs angiotensin-converting enzyme inhibitors, ARBs angiotensin receptor blockers, CCBs calcium channel blockers, CCI Charlson-Deyo comorbidity index, CI confidence interval, DPP4is dipeptidyl peptidase-4 inhibitors, NSAIDs nonsteroidal anti-inflammatory drugs, OADs oral antidiabetic drugs, OR odds ratio, Ref. reference group.
fonc-12-840142-g002.jpg
PMC9120816_01_fonc-12-840142-g002.jpg
f2
Figure 2 , indicating the tumor promoting effect of DPP4is might be masked by metformin in patients who received low dosed DPP4is. Furthermore, our study provided a novel finding that the dose-response curve of DPP4is exposure for colorectal cancer is J-shaped, indicating the dual effects of DPP4is.