Effect of Metformin on Lower Urinary Tract Symptoms in Male Patients with Type 2 Diabetes Mellitus: A Retrospective Cohort Study in Taiwan
Purpose: This study investigated the risk of lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH) associated with metformin use. Materials and Methods: We used the database of Taiwan’s National Health Insurance to create 9,833 pairs of ever users and never users of metformin mat...
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| Format: | Article |
| Language: | English |
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Korean Society for Sexual Medicine and Andrology
2023-07-01
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| Series: | The World Journal of Men's Health |
| Subjects: |
| _version_ | 1827921452125388800 |
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| author | Chin-Hsiao Tseng |
| author_facet | Chin-Hsiao Tseng |
| author_sort | Chin-Hsiao Tseng |
| collection | DOAJ |
| description | Purpose: This study investigated the risk of lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH) associated
with metformin use.
Materials and Methods: We used the database of Taiwan’s National Health Insurance to create 9,833 pairs of ever users and
never users of metformin matched on propensity score. They were males with a new diagnosis of type 2 diabetes during
1999–2005. The incidence of LUTS/BPH was calculated from January 1, 2006 until December 31, 2011. We estimated hazard
ratios by Cox regression weighted on propensity score.
Results: There were 515 incident cases in ever users after a median follow-up of 5.4 years (incidence rate: 11.24 per 1,000
person-years) and 682 cases in never users after 5.2 years (15.92 per 1,000 person-years). The hazard ratio (HR) that compared
ever to never users was 0.69 (95% confidence interval [CI], 0.62–0.78). The HRs that compared ever users categorized
into quartiles of cumulative duration (<19.33, 19.33–41.56, 41.57–67.17, and >67.17 mo) to never users were 1.02
(0.84–1.23), 1.01 (0.86–1.20), 0.57 (0.47–0.69), and 0.40 (0.32–0.49), respectively. For the quartiles of cumulative dose of
<582.00, 582.00–1,361.00, 1,361.01–2,449.00, and >2,449.00 g, the respective HRs were 1.03 (0.85–1.24), 0.96 (0.81–
1.13), 0.60 (0.49–0.72), and 0.40 (0.32–0.50). The lower risk was significant in all quartiles of defined daily dose. However, a
larger daily dose was associated with a greater risk reduction. There were no significant interactions between metformin and
other antidiabetic drugs. Patients who used rosiglitazone and/or pioglitazone without metformin had a significantly higher
risk (HR, 1.33; 95% CI, 1.09–1.63) and a combination with metformin attenuated such an adverse impact (HR, 0.78; 95%
CI, 0.66–0.91).
Conclusions: A significantly lower risk of LUTS/BPH is observed in males with type 2 diabetes who use metformin. |
| first_indexed | 2024-03-13T04:27:44Z |
| format | Article |
| id | doaj.art-4c59fca7f1564f45b01b8a681776d436 |
| institution | Directory Open Access Journal |
| issn | 2287-4208 2287-4690 |
| language | English |
| last_indexed | 2024-03-13T04:27:44Z |
| publishDate | 2023-07-01 |
| publisher | Korean Society for Sexual Medicine and Andrology |
| record_format | Article |
| series | The World Journal of Men's Health |
| spelling | doaj.art-4c59fca7f1564f45b01b8a681776d4362023-06-20T02:38:03ZengKorean Society for Sexual Medicine and AndrologyThe World Journal of Men's Health2287-42082287-46902023-07-0141368069110.5534/wjmh.220133Effect of Metformin on Lower Urinary Tract Symptoms in Male Patients with Type 2 Diabetes Mellitus: A Retrospective Cohort Study in TaiwanChin-Hsiao Tseng0https://orcid.org/0000-0001-9545-7123Department of Internal Medicine, National Taiwan University College of MedicinePurpose: This study investigated the risk of lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH) associated with metformin use. Materials and Methods: We used the database of Taiwan’s National Health Insurance to create 9,833 pairs of ever users and never users of metformin matched on propensity score. They were males with a new diagnosis of type 2 diabetes during 1999–2005. The incidence of LUTS/BPH was calculated from January 1, 2006 until December 31, 2011. We estimated hazard ratios by Cox regression weighted on propensity score. Results: There were 515 incident cases in ever users after a median follow-up of 5.4 years (incidence rate: 11.24 per 1,000 person-years) and 682 cases in never users after 5.2 years (15.92 per 1,000 person-years). The hazard ratio (HR) that compared ever to never users was 0.69 (95% confidence interval [CI], 0.62–0.78). The HRs that compared ever users categorized into quartiles of cumulative duration (<19.33, 19.33–41.56, 41.57–67.17, and >67.17 mo) to never users were 1.02 (0.84–1.23), 1.01 (0.86–1.20), 0.57 (0.47–0.69), and 0.40 (0.32–0.49), respectively. For the quartiles of cumulative dose of <582.00, 582.00–1,361.00, 1,361.01–2,449.00, and >2,449.00 g, the respective HRs were 1.03 (0.85–1.24), 0.96 (0.81– 1.13), 0.60 (0.49–0.72), and 0.40 (0.32–0.50). The lower risk was significant in all quartiles of defined daily dose. However, a larger daily dose was associated with a greater risk reduction. There were no significant interactions between metformin and other antidiabetic drugs. Patients who used rosiglitazone and/or pioglitazone without metformin had a significantly higher risk (HR, 1.33; 95% CI, 1.09–1.63) and a combination with metformin attenuated such an adverse impact (HR, 0.78; 95% CI, 0.66–0.91). Conclusions: A significantly lower risk of LUTS/BPH is observed in males with type 2 diabetes who use metformin.benign prostatic hyperplasialower urinary tract symptomsmetforminnational health insurancepharmacoepidemiologytaiwan |
| spellingShingle | Chin-Hsiao Tseng Effect of Metformin on Lower Urinary Tract Symptoms in Male Patients with Type 2 Diabetes Mellitus: A Retrospective Cohort Study in Taiwan The World Journal of Men's Health benign prostatic hyperplasia lower urinary tract symptoms metformin national health insurance pharmacoepidemiology taiwan |
| title | Effect of Metformin on Lower Urinary Tract Symptoms in Male Patients with Type 2 Diabetes Mellitus: A Retrospective Cohort Study in Taiwan |
| title_full | Effect of Metformin on Lower Urinary Tract Symptoms in Male Patients with Type 2 Diabetes Mellitus: A Retrospective Cohort Study in Taiwan |
| title_fullStr | Effect of Metformin on Lower Urinary Tract Symptoms in Male Patients with Type 2 Diabetes Mellitus: A Retrospective Cohort Study in Taiwan |
| title_full_unstemmed | Effect of Metformin on Lower Urinary Tract Symptoms in Male Patients with Type 2 Diabetes Mellitus: A Retrospective Cohort Study in Taiwan |
| title_short | Effect of Metformin on Lower Urinary Tract Symptoms in Male Patients with Type 2 Diabetes Mellitus: A Retrospective Cohort Study in Taiwan |
| title_sort | effect of metformin on lower urinary tract symptoms in male patients with type 2 diabetes mellitus a retrospective cohort study in taiwan |
| topic | benign prostatic hyperplasia lower urinary tract symptoms metformin national health insurance pharmacoepidemiology taiwan |
| work_keys_str_mv | AT chinhsiaotseng effectofmetforminonlowerurinarytractsymptomsinmalepatientswithtype2diabetesmellitusaretrospectivecohortstudyintaiwan |