由于共享危险因素、代谢功能障碍和使用抗糖尿病药物，已经提出糖尿病（DM）与乳腺癌（BCa）风险呈正相关。我们进行了一项系统综述和荟萃分析，以评估DM与BCa风险之间的关联。我们在2021年12月10日之前，在PubMed、Embase和Web of Science上搜索了对DM和BCa之间的关联进行评估的队列研究和病例对照研究。两位评审者独立筛选研究进行纳入、摘录文章数据并评价研究质量。采用随机效应模型估计总体风险比（RR）和95%置信区间（CI）。在初始搜索中确定的8396篇文章中，共有70个独立研究包含在荟萃分析中。DM与BCa的总体风险增加有关（RR = 1.20，95% CI：1.11-1.29）。24项病例对照研究呈现更强的关联（RR = 1.26，95% CI：1.13-1.40）比46项队列研究（RR = 1.15，95% CI：1.05-1.27）。根据更年期状态报告风险的研究发现，绝经后妇女患BCa的风险升高（RR = 1.12，95% CI：1.07-1.17）。而绝经前妇女DM与BCa风险之间没有关联（RR = 0.95，95% CI：0.85-1.05）。此外，DM与雌激素受体（ER）阳性（RR = 1.09，95% CI：1.00-1.20）、ER阴性（RR = 1.16，95% CI：1.04-1.30）和三阴性BCa（RR = 1.41，95% CI：1.01-1.96）之间存在显著增加的风险。人皮肤生长因子受体2阳性BCa的关联估计结果也呈阳性（RR = 1.21，95% CI：0.52-2.82），但置信区间较宽，穿越了零点。我们的荟萃分析确认了DM与BCa风险之间的温和正相关。此外，我们的结果表明，DM与BCa之间的关联可能受更年期状态的调节，并且DM可能与由受体状态定义的BCa亚型不同相关。有必要进行进一步的研究以探究这些关联的机制和DM对BCa受体表达的任何影响。© 2023 The Authors. Diabetes/Metabolism Research and Reviews由John Wiley＆Sons Ltd出版。

Diabetes mellitus (DM) has been proposed to be positively associated with breast cancer (BCa) risk due to shared risk factors, metabolic dysfunction, and the use of antidiabetic medications. We conducted a systematic review and meta-analysis to evaluate the association between DM and BCa risk. We searched PubMed, Embase, and Web of Science for cohort and case-control studies assessing the association between DM and BCa published before 10 December 2021. Two reviewers independently screened the studies for inclusion, abstracted article data, and rated study quality. Random effects models were used to estimate summary risk ratios (RRs) and 95% confidence intervals (CIs). From 8396 articles identified in the initial search, 70 independent studies were included in the meta-analysis. DM was associated with an overall increased risk of BCa (RR = 1.20, 95% CI: 1.11-1.29). The 24 case-control studies demonstrated a stronger association (RR = 1.26, 95% CI: 1.13-1.40) than the 46 cohort studies (RR = 1.15, 95% CI: 1.05-1.27). Studies reporting risk by menopausal status found that postmenopausal women had an elevated risk of developing BCa (RR = 1.12, 95% CI: 1.07-1.17). No association between DM and BCa risk was observed among premenopausal women (RR = 0.95, 95% CI: 0.85-1.05). In addition, DM was associated with significantly increased risks of oestrogen receptor (ER)+ (RR = 1.09, 95% CI: 1.00-1.20), ER- (RR = 1.16, 95% CI: 1.04-1.30), and triple negative BCa (RR = 1.41, 95% CI: 1.01-1.96). The association estimate for human epidermal growth factor 2-positive BCa was also positive (RR = 1.21, 95% CI: 0.52-2.82), but the CI was wide and crossed the null. Our meta-analysis confirms a modest positive association between DM and BCa risk. In addition, our results suggest that the association between DM and BCa may be modified by menopausal status, and that DM may be differentially associated with BCa subtypes defined by receptor status. Additional studies are warranted to investigate the mechanisms underlying these associations and any influence of DM on BCa receptor expression.© 2023 The Authors. Diabetes/Metabolism Research and Reviews published by John Wiley & Sons Ltd.