Renal protective effect of metformin in type 2 diabetes patients.

IF 5 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Journal of Clinical Endocrinology & Metabolism Pub Date : 2024-07-11 DOI:10.1210/clinem/dgae477
Hsi-Hao Wang, Sheng-Hsiang Lin, Shih-Yuan Hung, Yuan-Yow Chiou, Wan-Chia Hsu, Chih-Min Chang, Hung-Hsiang Liou, Min-Yu Chang, Li-Chun Ho, Ching-Fang Wu, Yi-Che Lee
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Abstract

Background: Inhibiting the development and progression of diabetic kidney disease (DKD) is an important issue, but the renoprotective effect of metformin is still controversial.

Aims: To assess the renoprotective effect of metformin in patients with type 2 diabetes.

Methods: This retrospective observational multicenter cohort study included 316,693 patients with type 2 diabetes from seven hospital. After age, gender, medical year, baseline estimated glomerular filtration rate (eGFR), urine protein (dipstick), glycated hemoglobin (HbA1C) and propensity score matching; a total of 13,096 metformin and 13,096 non-metformin patients were included. The main results were doubling of serum creatinine, eGFR ≤ 15 mL/min/1.73 m2 and end stage kidney disease (ESKD).

Results: After conducting a multivariable logistic regression analysis on the variables, the metformin group was revealed to have better renal outcomes than non-metformin group, including a lower incidence of doubling of serum creatinine (hazard ratio [HR], 0.71; 95% CI, 0.65-0.77), eGFR ≤ 15 mL/min/1.73 m2 (HR 0.61; 95% CI 0.53-0.71), and ESKD (HR 0.55; 95% CI 0.47-0.66). The subgroup analyses revealed a consistent renoprotective effect across patients with various renal functions. Furthermore, when considering factors such as age, sex, comorbidities, and medications in subgroup analyses, it consistently showed that the metformin group experienced a slower deterioration in renal function across nearly all patient subgroups.

Conclusions: Metformin decreased the risk of renal function deterioration.

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二甲双胍对 2 型糖尿病患者肾脏的保护作用。
背景:目的:评估二甲双胍对2型糖尿病患者肾脏的保护作用:这项回顾性多中心队列研究纳入了 7 家医院的 316 693 名 2 型糖尿病患者。经过年龄、性别、医疗年限、基线肾小球滤过率(eGFR)、尿蛋白(dipstick)、糖化血红蛋白(HbA1C)和倾向评分匹配后,共纳入了13096名二甲双胍患者和13096名非二甲双胍患者。主要结果是血清肌酐翻倍、eGFR ≤ 15 mL/min/1.73 m2 和终末期肾病(ESKD):对变量进行多变量逻辑回归分析后发现,二甲双胍组的肾脏预后优于非二甲双胍组,包括血清肌酐加倍(危险比 [HR],0.71;95% CI,0.65-0.77)、eGFR ≤ 15 mL/min/1.73 m2(HR 0.61;95% CI 0.53-0.71)和 ESKD(HR 0.55;95% CI 0.47-0.66)的发生率较低。亚组分析显示,对不同肾功能的患者具有一致的肾保护作用。此外,在亚组分析中考虑年龄、性别、合并症和药物等因素时,结果一致显示,在几乎所有患者亚组中,二甲双胍组的肾功能恶化速度较慢:结论:二甲双胍降低了肾功能恶化的风险。
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来源期刊
Journal of Clinical Endocrinology & Metabolism
Journal of Clinical Endocrinology & Metabolism 医学-内分泌学与代谢
CiteScore
11.40
自引率
5.20%
发文量
673
审稿时长
1 months
期刊介绍: The Journal of Clinical Endocrinology & Metabolism is the world"s leading peer-reviewed journal for endocrine clinical research and cutting edge clinical practice reviews. Each issue provides the latest in-depth coverage of new developments enhancing our understanding, diagnosis and treatment of endocrine and metabolic disorders. Regular features of special interest to endocrine consultants include clinical trials, clinical reviews, clinical practice guidelines, case seminars, and controversies in clinical endocrinology, as well as original reports of the most important advances in patient-oriented endocrine and metabolic research. According to the latest Thomson Reuters Journal Citation Report, JCE&M articles were cited 64,185 times in 2008.
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