The Joanna Briggs Institute, The University of Adelaide, Adelaide, South Australia, Australia; Centre for Nanoscale BioPhotonics, Macquarie University, Sydney, New South Wales, Australia.
The Joanna Briggs Institute, The University of Adelaide, Adelaide, South Australia, Australia.
Ageing Res Rev. 2017 Nov;40:31-44. doi: 10.1016/j.arr.2017.08.003. Epub 2017 Aug 10.
This systematic review investigated whether the insulin sensitiser metformin has a geroprotective effect in humans. Pubmed and Embase were searched along with databases of unpublished studies. Eligible research investigated the effect of metformin on all-cause mortality or diseases of ageing relative to non-diabetic populations or diabetics receiving other therapies with adjustment for disease control achieved. Overall, 260 full-texts were reviewed and 53 met the inclusion criteria. Diabetics taking metformin had significantly lower all-cause mortality than non-diabetics (hazard ratio (HR)=0.93, 95%CI 0.88-0.99), as did diabetics taking metformin compared to diabetics receiving non-metformin therapies (HR=0.72, 95%CI 0.65-0.80), insulin (HR=0.68, 95%CI 0.63-0.75) or sulphonylurea (HR=0.80, 95%CI 0.66-0.97). Metformin users also had reduced cancer compared to non-diabetics (rate ratio=0.94, 95%CI 0.92-0.97) and cardiovascular disease (CVD) compared to diabetics receiving non-metformin therapies (HR=0.76, 95%CI 0.66-0.87) or insulin (HR=0.78, 95%CI 0.73-0.83). Differences in baseline characteristics were observed which had the potential to bias findings, although statistical adjustments were made. The apparent reductions in all-cause mortality and diseases of ageing associated with metformin use suggest that metformin could be extending life and healthspans by acting as a geroprotective agent.
本系统评价研究了胰岛素增敏剂二甲双胍是否对人类具有抗衰老作用。检索了 PubMed 和 Embase 以及未发表研究数据库。符合条件的研究调查了二甲双胍对全因死亡率或衰老相关疾病的影响，相对于非糖尿病人群或接受其他治疗的糖尿病患者，这些研究调整了疾病控制情况。总共审查了 260 篇全文，其中 53 篇符合纳入标准。服用二甲双胍的糖尿病患者的全因死亡率明显低于非糖尿病患者（风险比 (HR)=0.93，95%CI 0.88-0.99），服用二甲双胍的糖尿病患者也明显低于接受非二甲双胍治疗的糖尿病患者（HR=0.72，95%CI 0.65-0.80）、胰岛素（HR=0.68，95%CI 0.63-0.75）或磺脲类药物（HR=0.80，95%CI 0.66-0.97）。与非糖尿病患者相比，二甲双胍使用者的癌症发生率也有所降低（率比=0.94，95%CI 0.92-0.97），与接受非二甲双胍治疗的糖尿病患者（HR=0.76，95%CI 0.66-0.87）或胰岛素（HR=0.78，95%CI 0.73-0.83）相比，心血管疾病 (CVD) 的发生率也有所降低。观察到基线特征存在差异，这有可能影响研究结果，但已进行了统计学调整。与二甲双胍使用相关的全因死亡率和衰老相关疾病的明显降低表明，二甲双胍可能通过作为一种抗衰老剂来延长寿命和健康寿命。
