Department of Medicine, Division of Cardiology, Einstein Institute for Aging Research, Fleischer Institute for Diabetes Research (FIDAM), Einstein - Mount Sinai Diabetes Research Center (ES-DRC), Albert Einstein College of Medicine, New York City, NY, USA.
ASL Avellino, Avellino, Italy.
Cardiovasc Diabetol. 2023 Apr 21;22(1):94. doi: 10.1186/s12933-023-01817-4.
Women have a high risk of frailty independently of age and menopause state. Diabetes and hypertension increase the risk of frailty and cognitive impairment. Metformin has been employed in post-menopausal women and some reports have shown encouraging effects in terms of attenuated frailty. However, the impact on cognitive performance of a recently introduced extended-release formulation of metformin has never been explored.
We studied consecutive frail hypertensive and diabetic older women presenting at the ASL (local health authority of the Italian Ministry of Health) Avellino, Italy, from June 2021 to August 2022, who were treated or not with extended-release metformin. We included a control group of frail older males with diabetes and hypertension treated with extended-release metformin and a control group of frail older women with diabetes and hypertension treated with regular metformin.
A total of 145 patients successfully completed the study. At the end of the 6-month follow-up, we observed a significantly different cognitive performance compared to baseline in the group of frail women treated with extended-release metformin (p: 0.007). Then, we compared the follow-up groups and we observed significant differences between frail women treated vs. untreated (p: 0.041), between treated frail women and treated frail men (p: 0.016), and between women treated with extended-release metformin vs. women treated with regular metformin (p: 0.048). We confirmed the crucial role of extended-release metformin applying a multivariable logistic analysis to adjust for potential confounders.
We evidenced, for the first time to the best of our knowledge, the favorable effects on cognitive impairment of extended-release metformin in frail women with diabetes and hypertension.
女性无论年龄和绝经状态如何，都有很高的脆弱性风险。糖尿病和高血压会增加脆弱性和认知障碍的风险。二甲双胍已在绝经后妇女中使用，一些报告显示其在减轻脆弱性方面有令人鼓舞的效果。然而，最近推出的二甲双胍缓释制剂对认知表现的影响从未被探索过。
我们研究了 2021 年 6 月至 2022 年 8 月期间连续就诊于意大利卫生部 ASL（地方卫生当局）阿韦利诺的患有高血压和糖尿病的脆弱老年女性，这些患者接受或未接受缓释二甲双胍治疗。我们纳入了一组接受缓释二甲双胍治疗的患有糖尿病和高血压的脆弱老年男性对照组，以及一组接受常规二甲双胍治疗的患有糖尿病和高血压的脆弱老年女性对照组。
共有 145 名患者成功完成了研究。在 6 个月的随访结束时，我们观察到接受缓释二甲双胍治疗的脆弱女性组与基线相比认知表现有显著差异（p：0.007）。然后，我们比较了随访组，观察到接受治疗的脆弱女性与未接受治疗的脆弱女性之间存在显著差异（p：0.041），接受治疗的脆弱女性与接受治疗的脆弱男性之间存在显著差异（p：0.016），以及接受缓释二甲双胍治疗的女性与接受常规二甲双胍治疗的女性之间存在显著差异（p：0.048）。我们通过多变量逻辑分析来调整潜在混杂因素，证实了缓释二甲双胍的关键作用。
我们首次证明，在患有糖尿病和高血压的脆弱女性中，缓释二甲双胍对认知障碍有有利影响。
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