Graduate School of Dalian Medical University, Dalian Medical University, Dalian, China.
Department of Cardiology, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou, China.
Aging (Albany NY). 2024 Apr 26;16(9):7668-7682. doi: 10.18632/aging.205775.
The cardiovascular effects of metformin continue to be a subject of debate within the medical community.
The Mendelian randomization (MR) study used data from genome-wide association studies (GWAS) to explore the causal association with six diseases that are associated with bimatoprost treatment and myocardial infarction, chronic heart failure, atrial fibrillation, hypertrophic and dilated cardiomyopathy, and valvular disease. Genome-wide significant single nucleotide polymorphisms (SNPs), that are associated with metformin use were selected as the instrumental variables. To determine the causal relationship between metformin use and various cardiovascular diseases, MR analysis was conducted, employing methods such as Instrumental Variable Weighting (IVW).
The IVW analysis demonstrated a positive association between metformin treatment and the risk of myocardial infarction (OR = 22.67, 95% CI 3.22-34.01; = 0.002). Conversely, metformin treatment exhibited a negative association with the risk of developing valvular disease (OR = 0.98, 95% CI 0.95-1.00; = 0.046) and hypertrophic cardiomyopathy (OR = 0.01, 95% CI 0.00-0.22; = 0.016). Multiple test correction found that metformin treatment was causally associated with the risk of both hypertrophic cardiomyopathy ( = 0.048) and myocardial infarction ( = 0.012). The analysis revealed limited heterogeneity in the individual results, absence of pleiotropy evidence, and indications of stability in the findings.
The MR study discovered from a genetic standpoint that metformin may lower the risk of hypertrophic cardiomyopathy and valvular heart disease, yet it could elevate the risk of myocardial infarction.
二甲双胍的心血管效应在医学界仍然是一个争论的话题。
孟德尔随机化（MR）研究使用全基因组关联研究（GWAS）的数据来探讨与碧美前列素治疗和心肌梗死、慢性心力衰竭、心房颤动、肥厚型和扩张型心肌病以及瓣膜病相关的六种疾病的因果关联。与二甲双胍使用相关的全基因组显著单核苷酸多态性（SNP）被选为工具变量。为了确定二甲双胍使用与各种心血管疾病之间的因果关系，进行了 MR 分析，采用了工具变量加权（IVW）等方法。
IVW 分析表明，二甲双胍治疗与心肌梗死风险之间存在正相关（OR=22.67，95%CI 3.22-34.01； =0.002）。相反，二甲双胍治疗与瓣膜病（OR=0.98，95%CI 0.95-1.00； =0.046）和肥厚型心肌病（OR=0.01，95%CI 0.00-0.22； =0.016）的发病风险呈负相关。多重检验校正发现，二甲双胍治疗与肥厚型心肌病（ =0.048）和心肌梗死（ =0.012）的发病风险存在因果关系。个体结果的异质性有限，没有多效性证据，并且结果稳定。
从遗传角度来看，MR 研究发现二甲双胍可能降低肥厚型心肌病和瓣膜性心脏病的风险，但可能增加心肌梗死的风险。
