Reduced mortality from lower respiratory tract disease in adult diabetic patients treated with metformin.
Adult
Aged
Cross-Sectional Studies
Diabetes Mellitus, Type 2
/ drug therapy
Female
Follow-Up Studies
Humans
Hypoglycemic Agents
/ therapeutic use
Male
Metformin
/ therapeutic use
Middle Aged
Nutrition Surveys
Respiratory Tract Diseases
/ complications
Survival Rate
/ trends
Time Factors
United States
/ epidemiology
asthma
chronic obstructive pulmonary disease
diabetes
metformin
mortality
Journal
Respirology (Carlton, Vic.)
ISSN: 1440-1843
Titre abrégé: Respirology
Pays: Australia
ID NLM: 9616368
Informations de publication
Date de publication:
07 2019
07 2019
Historique:
received:
27
08
2018
revised:
21
11
2018
accepted:
08
01
2019
pubmed:
15
2
2019
medline:
28
4
2020
entrez:
15
2
2019
Statut:
ppublish
Résumé
Chronic lower respiratory diseases (CLRD) increase the risk of type 2 diabetes, which in turn may worsen lung function. Metformin, a common antidiabetic with anti-inflammatory and antioxidant properties, may improve respiratory outcomes. Therefore, we examined the association of metformin use with the risk of mortality from CLRD. We analysed data from the National Health and Nutrition Examination Survey during 1988-1994 and 1999-2010 for participants aged 40 years or older who had diabetes and were followed up for mortality through 2011. Information on prescription medicine was collected at baseline and CLRD-related mortality during follow-up was defined using the 10th Revision of the International Classification of Diseases (ICD-10). Cox proportional hazards modelling was used to determine the mortality hazard ratio (HR) associated with metformin use, adjusting for relevant covariates. A total of 5266 participants with a median follow-up of 6.1 years were included. The prevalence of metformin use was 31.9% and 1869 participants died during follow-up, including 72 of CLRD. In the adjusted Cox proportional regression analysis, metformin was associated with a decreased risk of CLRD mortality in the overall population (HR: 0.39, 95% CI: 0.15-0.99) and among participants with baseline CLRD (HR: 0.30, 95% CI: 0.10-0.93), after adjusting for age, gender, race/ethnicity, cigarette smoking, body mass index, current asthma and chronic obstructive pulmonary disease (COPD), insulin and other diabetic medications, and glycohaemoglobin level. We found no association between other antidiabetic medications and CLRD mortality. In this sample representative of the U.S. population, metformin was associated with lower CLRD mortality in adults with diabetes.
Sections du résumé
BACKGROUND AND OBJECTIVE
Chronic lower respiratory diseases (CLRD) increase the risk of type 2 diabetes, which in turn may worsen lung function. Metformin, a common antidiabetic with anti-inflammatory and antioxidant properties, may improve respiratory outcomes. Therefore, we examined the association of metformin use with the risk of mortality from CLRD.
METHODS
We analysed data from the National Health and Nutrition Examination Survey during 1988-1994 and 1999-2010 for participants aged 40 years or older who had diabetes and were followed up for mortality through 2011. Information on prescription medicine was collected at baseline and CLRD-related mortality during follow-up was defined using the 10th Revision of the International Classification of Diseases (ICD-10). Cox proportional hazards modelling was used to determine the mortality hazard ratio (HR) associated with metformin use, adjusting for relevant covariates.
RESULTS
A total of 5266 participants with a median follow-up of 6.1 years were included. The prevalence of metformin use was 31.9% and 1869 participants died during follow-up, including 72 of CLRD. In the adjusted Cox proportional regression analysis, metformin was associated with a decreased risk of CLRD mortality in the overall population (HR: 0.39, 95% CI: 0.15-0.99) and among participants with baseline CLRD (HR: 0.30, 95% CI: 0.10-0.93), after adjusting for age, gender, race/ethnicity, cigarette smoking, body mass index, current asthma and chronic obstructive pulmonary disease (COPD), insulin and other diabetic medications, and glycohaemoglobin level. We found no association between other antidiabetic medications and CLRD mortality.
CONCLUSION
In this sample representative of the U.S. population, metformin was associated with lower CLRD mortality in adults with diabetes.
Identifiants
pubmed: 30761687
doi: 10.1111/resp.13486
pmc: PMC6579707
mid: NIHMS1013307
doi:
Substances chimiques
Hypoglycemic Agents
0
Metformin
9100L32L2N
Types de publication
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
646-651Subventions
Organisme : NHLBI NIH HHS
ID : K08 HL125666
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL107380
Pays : United States
Informations de copyright
© 2019 Asian Pacific Society of Respirology.
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