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Metformin use mitigates the adverse prognostic effect of diabetes mellitus in chronic obstructive pulmonary disease
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Metformin use mitigates the adverse prognostic effect of diabetes mellitus in chronic obstructive pulmonary disease
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Journal Article
Metformin use mitigates the adverse prognostic effect of diabetes mellitus in chronic obstructive pulmonary disease
2019
Overview
Background and objective
Among patients with chronic obstructive pulmonary disease (COPD), diabetes mellitus (DM) is a common comorbidity and is probably associated with increased systemic inflammation and worse prognosis. Metformin, with its pleiotropic anti-inflammatory and antioxidant actions, may offer theoretical benefits in COPD patients with DM. Thus, this study aimed to investigate the effects of DM and metformin use on mortality in the clinical trajectory of COPD.
Methods
This was a retrospective cohort study comprising patients with spirometry-confirmed COPD and an age of ≥40 years from 2008 to 2014. The primary outcome of interest was all-cause mortality. We evaluated the effects of DM on mortality through the clinical course of COPD and we also assessed the impact of metformin use on survival of the COPD population.
Results
Among 4231 COPD patients, 556 (13%) had DM, and these patients had 1.62 times higher hazards of 2-year mortality than those without DM (95% confidence interval [CI], 1.15–2.28) after adjusting for age, gender, COPD stage, comorbidities and prior COPD hospitalization. Over a 2-year period, metformin users had a significantly lower risk of death (hazard ratio, 0.46; 95% CI, 0.23–0.92) compared with non-metformin users in patients with coexistent COPD and DM. Moreover, metformin users had similar survival to COPD patients without DM.
Conclusions
This study shows that DM is associated with an increased risk of death in COPD patients and metformin use seems to mitigate the hazard. Our findings suggest a potential role of metformin in the management of DM in COPD.
Publisher
BioMed Central,BioMed Central Ltd,Nature Publishing Group,BMC
Subject
/ Chronic obstructive lung disease
/ Chronic obstructive pulmonary disease
/ Diabetes Mellitus - diagnosis
/ Diabetes Mellitus - drug therapy
/ Diabetes Mellitus - epidemiology
/ Female
/ Hazards
/ Humans
/ Hypoglycemic Agents - therapeutic use
/ Kinases
/ Male
/ Medicine
/ Outcome
/ Patients
/ Pneumology/Respiratory System
/ Pulmonary Disease, Chronic Obstructive - diagnosis
/ Pulmonary Disease, Chronic Obstructive - drug therapy
/ Pulmonary Disease, Chronic Obstructive - epidemiology
/ Survival
