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二甲双胍的使用与合并哮喘和糖尿病患者的哮喘结局。

Metformin use and asthma outcomes among patients with concurrent asthma and diabetes.

机构信息

Medical Affairs, AstraZeneca Taiwan Limited, Taipei, Taiwan.

Department of Clinical, Social and Administrative Sciences, College of Pharmacy, University of Michigan, Ann Arbor, Michigan, USA.

出版信息

Respirology. 2016 Oct;21(7):1210-8. doi: 10.1111/resp.12818. Epub 2016 May 31.

Abstract

BACKGROUND AND OBJECTIVE

Metformin is a first-line treatment for patients with diabetes. Recent animal studies indicated that metformin can reduce airway inflammation. However, it remains unclear whether the use of metformin can help patients maintain asthma control. The purpose of this study was to evaluate the association between the use of metformin and asthma-related outcomes, which include asthma-related hospitalization, asthma-related emergency room visits and asthma exacerbation, among patients with concurrent asthma and diabetes.

METHODS

We conducted an 11-year (2001-2011) retrospective cohort study using the Taiwan National Health Insurance Research Database. Patients with concurrent asthma and diabetes were included. The date of the first observed prescription of metformin was defined as the index date. For each metformin user, two matched metformin non-users of the same age and gender were randomly selected. Patients were followed for 3 years to measure the occurrence of asthma-related outcomes. Multivariable logistic regression models were used to assess the association between metformin use and asthma-related outcomes.

RESULTS

Of 1332 patients with concurrent asthma and diabetes, 444 (33.3%) were metformin users. Compared with non-users, metformin users had a lower risk of asthma-related hospitalization (OR = 0.21, 95% CI: 0.07-0.63) and asthma exacerbation (OR = 0.39, 95% CI: 0.19-0.79).

CONCLUSION

The risk of asthma-related outcomes was lower for metformin users than non-users. Health-care providers should consider metformin as a treatment strategy for patients with concurrent asthma and diabetes.

摘要

背景和目的

二甲双胍是糖尿病患者的一线治疗药物。最近的动物研究表明,二甲双胍可以减轻气道炎症。然而,目前尚不清楚使用二甲双胍是否可以帮助患者维持哮喘控制。本研究旨在评估同时患有哮喘和糖尿病的患者中,使用二甲双胍与哮喘相关结局(包括哮喘相关住院、哮喘相关急诊就诊和哮喘恶化)之间的关联。

方法

我们使用台湾全民健康保险研究数据库进行了一项为期 11 年(2001-2011 年)的回顾性队列研究。纳入同时患有哮喘和糖尿病的患者。将首次观察到的二甲双胍处方日期定义为索引日期。对于每位使用二甲双胍的患者,随机选择两名年龄和性别相同的未使用二甲双胍的患者作为对照。随访 3 年以测量哮喘相关结局的发生情况。采用多变量逻辑回归模型评估二甲双胍使用与哮喘相关结局之间的关联。

结果

在 1332 名同时患有哮喘和糖尿病的患者中,有 444 名(33.3%)为二甲双胍使用者。与非使用者相比,二甲双胍使用者的哮喘相关住院风险较低(OR=0.21,95%CI:0.07-0.63),哮喘恶化风险也较低(OR=0.39,95%CI:0.19-0.79)。

结论

与非使用者相比,二甲双胍使用者的哮喘相关结局风险较低。医疗保健提供者应考虑将二甲双胍作为同时患有哮喘和糖尿病患者的治疗策略。

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