Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Front Endocrinol (Lausanne). 2022 Oct 5;13:1036885. doi: 10.3389/fendo.2022.1036885. eCollection 2022.
To compare the risk of gingival and periodontal diseases (GPD) between ever users and never users of metformin in patients with type 2 diabetes mellitus.
The Taiwan's National Health Insurance database was used to enroll 423,949 patients with new onset diabetes mellitus from 1999 to 2005. After excluding ineligible patients, 60,309 ever users and 5578 never users were followed up for the incidence of GPD from January 1, 2006 until December 31, 2011. Propensity score-weighted hazard ratios were estimated by Cox regression.
GPD was newly diagnosed in 18,528 ever users (incidence: 7746.51 per 100,000 person-years) and 2283 never users (incidence: 12158.59 per 100,000 person-years). The hazard ratio that compared ever users to never users was 0.627 (95% confidence interval: 0.600-0.655). When metformin use was categorized by tertiles of cumulative duration and cumulative dose, the risk significantly reduced in a dose-response pattern when the cumulative duration reached approximately 2 years or the cumulative dose reached 670 grams. Analyses on the tertiles of defined daily dose of metformin showed that the reduction of GPD risk could be seen in all three subgroups but the benefit would be greater when the daily dose increased.
Long-term use of metformin is associated with a significantly reduced risk of GPD.
比较 2 型糖尿病患者中使用和未使用二甲双胍的患者发生牙龈和牙周疾病(GPD)的风险。
本研究使用台湾全民健康保险数据库,纳入 1999 年至 2005 年间新诊断为糖尿病的 423949 例患者。排除不符合条件的患者后,随访 2006 年 1 月 1 日至 2011 年 12 月 31 日期间 GPD 的发生率,其中 60309 例为二甲双胍的曾用者,5578 例为从未使用者。采用 Cox 回归估计倾向评分加权风险比。
曾用者中有 18528 例(发生率:7746.51/100000 人年)和从未使用者中有 2283 例(发生率:12158.59/100000 人年)新诊断为 GPD。与从未使用者相比,曾用者的风险比为 0.627(95%置信区间:0.600-0.655)。当按累积持续时间和累积剂量的三分位数对二甲双胍的使用进行分类时,在累积持续时间约为 2 年或累积剂量达到 670 克时,风险呈剂量反应模式显著降低。对二甲双胍的定义日剂量三分位数的分析表明,在所有三个亚组中均可降低 GPD 风险,但当每日剂量增加时,获益更大。
长期使用二甲双胍与 GPD 风险显著降低相关。