Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China.
Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China.
Medicine (Baltimore). 2024 Oct 4;103(40):e39785. doi: 10.1097/MD.0000000000039785.
Asthma and diabetes are prevalent chronic diseases affecting a significant population globally. Research has suggested that metformin, a commonly used medication for diabetes management, may also have beneficial effects in enhancing asthma outcomes. Considering the comorbidity of asthma and diabetes, a comprehensive analysis was performed to investigate the efficacy of metformin in reducing adverse outcomes of asthma patients with diabetes.
To gather relevant data, we conducted a systematic search of the PubMed, Embase, and CENTRAL databases for observational studies published prior to September 2023. We specifically looked for studies involving individuals diagnosed with both asthma and diabetes, comparing the incidence and severity of asthma exacerbations in metformin users versus nonusers. The inclusion criteria encompassed studies that recruited participants aged 18 years and older. The primary outcome of interest was the risk of newly developing asthma, while secondary outcomes included the adjusted risk of asthma-induced exacerbations, emergency room visits, and hospitalizations. All data analyses and visualizations were performed using the R programming language.
We identified and included 7 studies involving a total of 1,176,398 patients in our analysis. The pooled effect size indicated a potential reduction in the incidence of newly developed asthma among patients with type 2 diabetes who used metformin, although this finding did not reach statistical significance. Similar conclusions have also been observed in other outcomes, such as exacerbation, asthma-related emergency department visits, risk of systemic corticosteroid prescription. The only positive outcome is that the use of metformin can reduce the chance of patients being hospitalized due to asthma.
In most outcome indicators, it cannot be assumed that the use of metformin can reduce asthma-related adverse events. However, the conclusion is not so certain, and longer observation and more evidence are still required. Metformin still shows some potential in the intervention of respiratory diseases.
哮喘和糖尿病是全球范围内普遍存在的慢性疾病，影响着大量人群。研究表明，二甲双胍作为一种常用于糖尿病管理的药物，可能对改善哮喘结局也具有有益作用。鉴于哮喘和糖尿病的共病性，我们进行了一项全面分析，以研究二甲双胍在降低合并糖尿病的哮喘患者不良结局方面的疗效。
为了收集相关数据，我们对截至 2023 年 9 月发表的观察性研究进行了 PubMed、Embase 和 CENTRAL 数据库的系统检索。我们特别寻找了纳入同时诊断为哮喘和糖尿病的个体的研究，比较了二甲双胍使用者和非使用者中哮喘加重的发生率和严重程度。纳入标准包括招募年龄在 18 岁及以上的参与者的研究。主要结局是新发生哮喘的风险，次要结局包括哮喘加重的调整风险、急诊就诊和住院。所有数据分析和可视化均使用 R 编程语言进行。
我们共识别并纳入了 7 项研究，其中共纳入了 1176398 名患者。汇总的效应量表明，使用二甲双胍的 2 型糖尿病患者新发生哮喘的风险可能降低，但这一发现没有达到统计学意义。在其他结局（如加重、哮喘相关急诊就诊、全身皮质类固醇处方风险）中也观察到了类似的结论。唯一的阳性结果是二甲双胍的使用可以降低哮喘患者住院的机会。
在大多数结局指标中，不能假设使用二甲双胍可以减少与哮喘相关的不良事件。然而，这一结论并不确定，还需要更长时间的观察和更多的证据。二甲双胍在呼吸系统疾病的干预方面仍显示出一些潜力。
