Metformin use mitigates the adverse prognostic effect of diabetes mellitus in chronic obstructive pulmonary disease
Abstract 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 ac...
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| Format: | Article |
| Language: | English |
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BMC
2019-04-01
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| Series: | Respiratory Research |
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| Online Access: | http://link.springer.com/article/10.1186/s12931-019-1035-9 |
| _version_ | 1818885860665327616 |
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| author | Te-Wei Ho Chun-Ta Huang Yi-Ju Tsai Angela Shin-Yu Lien Feipei Lai Chong-Jen Yu |
| author_facet | Te-Wei Ho Chun-Ta Huang Yi-Ju Tsai Angela Shin-Yu Lien Feipei Lai Chong-Jen Yu |
| author_sort | Te-Wei Ho |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-19T16:12:09Z |
| format | Article |
| id | doaj.art-28c1b8a5e93a4864b6b18c187380a1b1 |
| institution | Directory Open Access Journal |
| issn | 1465-993X |
| language | English |
| last_indexed | 2024-12-19T16:12:09Z |
| publishDate | 2019-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Respiratory Research |
| spelling | doaj.art-28c1b8a5e93a4864b6b18c187380a1b12022-12-21T20:14:43ZengBMCRespiratory Research1465-993X2019-04-0120111010.1186/s12931-019-1035-9Metformin use mitigates the adverse prognostic effect of diabetes mellitus in chronic obstructive pulmonary diseaseTe-Wei Ho0Chun-Ta Huang1Yi-Ju Tsai2Angela Shin-Yu Lien3Feipei Lai4Chong-Jen Yu5Graduate Institute of Biomedical Electronics and Bioinformatics, College of Electrical Engineering and Computer Science, National Taiwan UniversityDepartment of Internal Medicine, National Taiwan University HospitalGraduate Institute of Biomedical and Pharmaceutical Science, College of Medicine, Fu Jen Catholic UniversitySchool of Nursing, College of Medicine, Chang Gung UniversityGraduate Institute of Biomedical Electronics and Bioinformatics, College of Electrical Engineering and Computer Science, National Taiwan UniversityDepartment of Internal Medicine, National Taiwan University HospitalAbstract 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.http://link.springer.com/article/10.1186/s12931-019-1035-9Chronic obstructive pulmonary diseaseComorbidityDiabetes mellitusMetforminOutcome |
| spellingShingle | Te-Wei Ho Chun-Ta Huang Yi-Ju Tsai Angela Shin-Yu Lien Feipei Lai Chong-Jen Yu Metformin use mitigates the adverse prognostic effect of diabetes mellitus in chronic obstructive pulmonary disease Respiratory Research Chronic obstructive pulmonary disease Comorbidity Diabetes mellitus Metformin Outcome |
| title | Metformin use mitigates the adverse prognostic effect of diabetes mellitus in chronic obstructive pulmonary disease |
| title_full | Metformin use mitigates the adverse prognostic effect of diabetes mellitus in chronic obstructive pulmonary disease |
| title_fullStr | Metformin use mitigates the adverse prognostic effect of diabetes mellitus in chronic obstructive pulmonary disease |
| title_full_unstemmed | Metformin use mitigates the adverse prognostic effect of diabetes mellitus in chronic obstructive pulmonary disease |
| title_short | Metformin use mitigates the adverse prognostic effect of diabetes mellitus in chronic obstructive pulmonary disease |
| title_sort | metformin use mitigates the adverse prognostic effect of diabetes mellitus in chronic obstructive pulmonary disease |
| topic | Chronic obstructive pulmonary disease Comorbidity Diabetes mellitus Metformin Outcome |
| url | http://link.springer.com/article/10.1186/s12931-019-1035-9 |
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