Yen Fu-Shun, Wei James Cheng-Chung, Shih Ying-Hsiu, Hsu Chung Y, Hsu Chih-Cheng, Hwu Chii-Min
Dr. Yen's Clinic, Taoyuan 33354, Taiwan.
Department of Allergy, Immunology & Rheumatology, Chung Shan Medical University Hospital, Taichung 40201, Taiwan.
Vaccines (Basel). 2022 Oct 19;10(10):1752. doi: 10.3390/vaccines10101752.
Older adults are more likely to have influenza and respond less well to the flu vaccine. We conducted this study to investigate whether pre-influenza vaccination metformin use had an effect on influenza and relevant complications in older adults with type 2 diabetes mellitus. Propensity score matching was used to identify 28,169 pairs of metformin users and nonusers from Taiwan's National Health Insurance Research Database from 1 January 2000 to 31 December 2018. We used Cox proportional hazards models to calculate the risks of hospitalization for influenza, pneumonia, cardiovascular disease, ventilation, and mortality between metformin users and nonusers. Compared with metformin nonusers, the aHRs (95% CI) for metformin users at risk of hospitalization for influenza, pneumonia, cardiovascular disease, invasive mechanical ventilation, death due to cardiovascular disease, and all-cause mortality were 0.60 (0.34, 1.060), 0.63 (0.53, 0.76), 0.41 (0.36, 0.47), 0.56 (0.45, 0.71), 0.49 (0.33, 0.73), and 0.44 (0.39, 0.51), respectively. Higher cumulative duration of metformin use was associated with lower risks of these outcomes than no use of metformin. This cohort study demonstrated that pre-influenza vaccination metformin use was associated with lower risks of hospitalizations for influenza, pneumonia, cardiovascular disease, mechanical ventilation, and mortality compared to metformin nonusers.
老年人更易感染流感，且对流感疫苗的反应较差。我们开展这项研究，旨在调查流感疫苗接种前使用二甲双胍是否会对老年2型糖尿病患者的流感及相关并发症产生影响。利用倾向评分匹配法，从台湾国民健康保险研究数据库中识别出2000年1月1日至2018年12月31日期间的28169对二甲双胍使用者和非使用者。我们使用Cox比例风险模型计算二甲双胍使用者和非使用者之间因流感、肺炎、心血管疾病、通气及死亡而住院的风险。与未使用二甲双胍的患者相比，使用二甲双胍的患者因流感、肺炎、心血管疾病、有创机械通气、心血管疾病死亡及全因死亡而住院的风险比（aHRs）（95%置信区间）分别为0.60（0.34，1.060）、0.63（0.53，0.76）、0.41（0.36，0.47）、0.56（0.45，0.71）、0.49（0.33，0.73）和0.44（0.39，0.51）。与未使用二甲双胍相比，二甲双胍使用的累积时长越长，这些结局的风险越低。这项队列研究表明，与未使用二甲双胍的患者相比，流感疫苗接种前使用二甲双胍与因流感、肺炎、心血管疾病、机械通气及死亡而住院的风险较低相关。
