Baskaran Dhanya, Aparicio-Ugarriza Raquel, Ferri-Guerra Juliana, Milyani Raneem, Florez Hermes, Ruiz Jorge G
Miami VAHS Geriatric Research Education and Clinical Center (GRECC), FL, USA.
Miller School of Medicine, University of Miami, FL, USA.
Gerontol Geriatr Med. 2020 Jun 15;6:2333721420924956. doi: 10.1177/2333721420924956. eCollection 2020 Jan-Dec.
Frailty is a state of vulnerability to stressors resulting in higher morbidity, mortality, and utilization in older adults. Frailty and type 2 diabetes mellitus share similar pathophysiological mechanisms which metformin may target. The purpose of this study was to determine whether exposure to metformin is associated with frailty in veterans. This is a cross-sectional study of veterans 65 years and older with type 2 diabetes who were screened for frailty between January 2016 and August 2017. We constructed a 44-item Frailty Index including multiple variables using a deficit accumulation framework. After adjustment for covariates, the association was calculated using binomial logistic regression models with frailty status as the outcome variable, and metformin exposure as the independent variable. Patients were 98.3% male and 56.7% White with a mean age of 72.9 ( = 6.8) years. The proportion of robust, prefrail and frail patients was 2.9% ( = 22), 46.7 % ( = 356) and 50.5% ( = 385), respectively. In binomial logistic regression, exposure to metformin was associated with lower risk for frailty, adjusted odds ratio (OR) = .55 (95% confidence interval [CI] = .39-.77), ≤ .001. This study shows that exposure to metformin was associated with lower risk for frailty in community-dwelling veterans.
衰弱是一种易受应激源影响的状态，会导致老年人发病率、死亡率升高及医疗资源利用率增加。衰弱和2型糖尿病具有相似的病理生理机制，而二甲双胍可能针对这些机制发挥作用。本研究的目的是确定退伍军人使用二甲双胍是否与衰弱有关。这是一项对2016年1月至2017年8月期间接受衰弱筛查的65岁及以上2型糖尿病退伍军人进行的横断面研究。我们使用缺陷积累框架构建了一个包含多个变量的44项衰弱指数。在对协变量进行调整后，以衰弱状态作为结果变量，二甲双胍暴露作为自变量，使用二项逻辑回归模型计算两者之间的关联。患者中男性占98.3%，白人占56.7%，平均年龄为72.9（标准差=6.8）岁。身体强壮、衰弱前期和衰弱患者的比例分别为2.9%（n=22）、46.7%（n=356）和50.5%（n=385）。在二项逻辑回归中，使用二甲双胍与较低的衰弱风险相关，调整后的优势比（OR）=0.55（95%置信区间[CI]=0.39 - 0.77），P≤0.001。本研究表明，在社区居住的退伍军人中，使用二甲双胍与较低的衰弱风险相关。
