Patients with type 2 diabetes (T2D) are at a higher risk of developing renal cell carcinoma (RCC) than the general population. In vitro and in vivo investigations of the effects of sodium glucose cotransporter‐2 inhibitors (SGLT2I) have shown a significantly reduced risk of RCC. However, the impact of these drugs on the incidence of RCC in the human population is unclear. This study aimed to examine the association between SGLT2I use and RCC risk in patients with T2D. We undertook a nationwide retrospective cohort study using the Health and Welfare Data Science Center database (2016–2020). The primary outcome was the risk of incident RCC by estimating hazard ratios (HRs) and 95% confidence intervals (CIs). Multiple Cox regression modeling was applied to analyze the association between SGLT2I use and RCC risk in patients with T2D. In a cohort of 241,772 patients with T2D who were using SGLT2Is and 483,544 participants who were not, 220 and 609 RCC cases, respectively, were recorded. The mean follow‐up period of the study subjects was 2 years. There was a decreased risk of RCC for SGLT2I users after adjusting for the index year, sex, age, comorbidities, and concurrent medication (adjusted HR 0.68; 95% CI, 0.58–0.81). The sensitivity test for the propensity score 1:1‐matched analyses showed similar results (adjusted HR 0.67; 95% CI, 0.55–0.81). The subgroup analysis revealed consistent results for sex, age (<70 years), and comorbidity with chronic kidney disease. The present study indicates that SGLT2I therapy significantly decreases RCC risk in patients with T2D. This finding was also consistent among the sensitivity test and subgroup analysis for those with or without chronic kidney disease/hypertension.

中文翻译：

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使用钠-葡萄糖协同转运蛋白-2抑制剂治疗的2型糖尿病患者患肾细胞癌的风险降低

2 型糖尿病 (T2D) 患者患肾细胞癌 (RCC) 的风险高于一般人群。对钠葡萄糖协同转运蛋白 2 抑制剂 (SGLT2I) 作用的体外和体内研究表明，肾细胞癌的风险显着降低。然而，这些药物对人群肾细胞癌发病率的影响尚不清楚。本研究旨在探讨 SGLT2I 使用与 T2D 患者 RCC 风险之间的关联。我们利用健康与福利数据科学中心数据库（2016-2020）进行了一项全国范围的回顾性队列研究。主要结果是通过估计风险比 (HR) 和 95% 置信区间 (CI) 来确定 RCC 事件的风险。应用多元 Cox 回归模型分析 SGLT2I 使用与 T2D 患者 RCC 风险之间的关联。在 241,772 名使用 SGLT2Is 的 T2D 患者和 483,544 名未使用 SGLT2Is 的参与者组成的队列中，分别记录了 220 例和 609 例 RCC 病例。研究对象的平均随访期为 2 年。调整指数年份、性别、年龄、合并症和同时用药后，SGLT2I 用户的 RCC 风险降低（调整后 HR 0.68；95% CI，0.58-0.81）。倾向评分 1:1 匹配分析的敏感性测试显示了相似的结果（调整后 HR 0.67；95% CI，0.55-0.81）。亚组分析显示性别、年龄（<70 岁）和慢性肾脏病合并症的结果一致。本研究表明，SGLT2I 治疗可显着降低 2 型糖尿病患者的肾细胞癌风险。这一发现在对患有或不患有慢性肾病/高血压的患者的敏感性测试和亚组分析中也一致。