二甲双胍与糖尿病患者慢性阻塞性肺疾病风险的关系。
Metformin and risk of chronic obstructive pulmonary disease in diabetes patients.
机构信息
Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China; Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, Republic of China; Division of Environmental Health and Occupational Medicine of the National Health Research Institutes, Zhunan, Taiwan, Republic of China.
出版信息
Diabetes Metab. 2019 Apr;45(2):184-190. doi: 10.1016/j.diabet.2018.05.001. Epub 2018 May 17.
PURPOSE
This study aimed to investigate whether metformin can affect risk of chronic obstructive pulmonary disease (COPD) in type 2 diabetes (T2D) patients.
METHODS
T2D patients newly diagnosed during 1999-2005 were enrolled from the reimbursement database of Taiwan's National Health Insurance system and followed up to 31 December 2011. Analyses were conducted in an unmatched cohort (92,272 ever-users and 10,697 never-users of metformin) and a propensity score (PS) matched pair cohort (10,697 ever-users and 10,697 never-users). Cox regression incorporated into the inverse probability of treatment weighting using the PS was used to estimate hazard ratios (HRs).
RESULTS
In the unmatched cohort, 2573 never-users and 13,840 ever-users developed COPD with respective incidences of 5994.64 and 3393.19 per 100,000 person-years. The overall HR was 0.560 (95% confidence interval [CI]: 0.537-0.584). HRs for the first (<25.27months), second (25.27-55.97months) and third (>55.97months) tertiles of cumulative duration were 1.021 (0.975-1.070), 0.575 (0.548-0.603) and 0.265 (0.252-0.280), respectively. Analyses of the matched cohort showed an overall HR of 0.643 (0.605-0.682), with HRs of 1.212 (1.122-1.309), 0.631 (0.578-0.689) and 0.305 (0.273-0.340) for the respective tertiles.
CONCLUSION
A reduced risk of COPD is observed in metformin users with T2D.
目的
本研究旨在探讨二甲双胍是否会影响 2 型糖尿病（T2D）患者患慢性阻塞性肺疾病（COPD）的风险。
方法
从台湾全民健康保险理赔资料库中招募 1999 年至 2005 年期间新诊断为 T2D 的患者，并随访至 2011 年 12 月 31 日。在未匹配队列（92272 例二甲双胍既往使用者和 10697 例从未使用者）和倾向评分（PS）匹配对队列（10697 例二甲双胍既往使用者和 10697 例从未使用者）中进行分析。采用纳入 PS 的治疗逆概率加权的 Cox 回归来估计风险比（HRs）。
结果
在未匹配队列中，2573 例从未使用者和 13840 例二甲双胍既往使用者发生 COPD，相应的发病率为 5994.64 和 3393.19/100000 人年。总体 HR 为 0.560（95%置信区间[CI]：0.537-0.584）。累积持续时间的前（<25.27 个月）、中（25.27-55.97 个月）和后（>55.97 个月）三分位的 HR 分别为 1.021（0.975-1.070）、0.575（0.548-0.603）和 0.265（0.252-0.280）。匹配队列的分析显示，总体 HR 为 0.643（0.605-0.682），相应三分位的 HR 分别为 1.212（1.122-1.309）、0.631（0.578-0.689）和 0.305（0.273-0.340）。
结论
在患有 T2D 的二甲双胍使用者中，COPD 的发病风险降低。
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