Associations of statins and diabetes with diagnosis of ulcerated cutaneous melanoma

von Schuckmann, Lena A., Smith, David, Hughes, Maria Celia B., Malt, Maryrose, van der Pols, Jolieke C., Khosrotehrani, Kiarash, Smithers, Bernard M. and Green, Adele C. (2017) Associations of statins and diabetes with diagnosis of ulcerated cutaneous melanoma. Journal of Investigative Dermatology, 137 12: 2599-2605. doi:10.1016/j.jid.2017.07.836

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Author von Schuckmann, Lena A.
Smith, David
Hughes, Maria Celia B.
Malt, Maryrose
van der Pols, Jolieke C.
Khosrotehrani, Kiarash
Smithers, Bernard M.
Green, Adele C.
Title Associations of statins and diabetes with diagnosis of ulcerated cutaneous melanoma
Journal name Journal of Investigative Dermatology   Check publisher's open access policy
ISSN 0022-202X
1523-1747
Publication date 2017-08-23
Year available 2017
Sub-type Article (original research)
DOI 10.1016/j.jid.2017.07.836
Open Access Status Not yet assessed
Volume 137
Issue 12
Start page 2599
End page 2605
Total pages 20
Place of publication London, United Kingdom
Publisher Nature Publishing Group
Language eng
Subject 1303 Biochemistry
1312 Molecular Biology
2708 Dermatology
1307 Cell Biology
Abstract Ulcerated primary melanomas are associated with an inflammatory tumor microenvironment. We hypothesized that systemic proinflammatory states and anti-inflammatory medications are also associated with a diagnosis of ulcerated melanoma. In a cross-sectional study of 787 patients with newly diagnosed clinical stage IB or II melanoma, we estimated odds ratios for the association of proinflammatory factors (high body mass index, diabetes, cardiovascular disease, hypertension, and smoking) or the use of anti-inflammatory medications (statins, aspirin, corticosteroids, and nonsteroidal anti-inflammatory drugs), with ulcerated primary melanoma using regression models and subgroup analyses to control for melanoma thickness and mitotic rate. On the basis of information from 194 patients with ulcerated and 593 patients with nonulcerated primary melanomas, regular statin users had lower likelihood of a diagnosis of ulcerated primary melanoma (odds ratio 0.67, 95% confidence interval 0.45-0.99), and this association remained after adjusting for age, sex, thickness, and mitosis. When analysis was limited to melanomas that were <= 2 mm thick and had <= 2 mitoses/mm 2 (40 ulcerated; 289 without ulceration), patients with diabetes had significantly raised odds of diagnosis of ulcerated melanoma (odds ratio 2.90, 95% confidence interval 1.07-7.90), adjusted for age, sex, body mass index, and statin use. These findings support our hypotheses that statin use is inversely associated, and diabetes is positively associated, with ulcerated melanoma.
Formatted abstract
Ulcerated primary melanomas are associated with an inflammatory tumor microenvironment. We hypothesized that systemic proinflammatory states and anti-inflammatory medications are also associated with a diagnosis of ulcerated melanoma. In a cross-sectional study of 787 patients with newly diagnosed clinical stage IB or II melanoma, we estimated odds ratios for the association of proinflammatory factors (high body mass index, diabetes, cardiovascular disease, hypertension, and smoking) or the use of anti-inflammatory medications (statins, aspirin, corticosteroids, and nonsteroidal anti-inflammatory drugs), with ulcerated primary melanoma using regression models and subgroup analyses to control for melanoma thickness and mitotic rate. On the basis of information from 194 patients with ulcerated and 593 patients with nonulcerated primary melanomas, regular statin users had lower likelihood of a diagnosis of ulcerated primary melanoma (odds ratio 0.67, 95% confidence interval 0.45–0.99), and this association remained after adjusting for age, sex, thickness, and mitosis. When analysis was limited to melanomas that were ≤2 mm thick and had ≤2 mitoses/mm2 (40 ulcerated; 289 without ulceration), patients with diabetes had significantly raised odds of diagnosis of ulcerated melanoma (odds ratio 2.90, 95% confidence interval 1.07–7.90), adjusted for age, sex, body mass index, and statin use. These findings support our hypotheses that statin use is inversely associated, and diabetes is positively associated, with ulcerated melanoma.
Keyword Prognostic-Significance
Cancer
Inflammation
Therapy
Risk
Metaanalysis
Mortality
Prevention
Biomarkers
Disease
Q-Index Code C1
Q-Index Status Provisional Code
Grant ID 1073898
1133317
Institutional Status UQ

 
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Created: Tue, 10 Oct 2017, 08:01:37 EST by Lena Von Schuckmann on behalf of School of Public Health