Enderami Athena, Shariati Behnam, Zarghami Mehran, Aliasgharian Aily, Ghazaiean Mobin, Darvishi-Khezri Hadi
Department of Psychiatry, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
Mental Health Research Center, Iran University of Medical Sciences, Tehran, Iran.
Neuropsychopharmacol Rep. 2025 Mar;45(1):e12528. doi: 10.1002/npr2.12528.
Contradictory results for the association between metformin intake and changes in cognitive function have been reported. We attempted to overview systematic reviews and meta-analyses showing the role of metformin, as mono or combination therapy, in cognitive performance alterations among patients with type 2 diabetes mellitus (T2DM) and to determine the quality of the evidence as well. To find the English-written reviews, a literature search was conducted on PubMed, Web of Science, Scopus, Cochrane Library, Trip, and Google Scholar by May 1, 2023. The literature search unearthed 2672 records, 10 of which were included in the study. Metformin may provide cognitive benefits for patients with type 2 diabetes, as evidence suggests potential improvements in memory and a reduced risk of neurodegenerative diseases. Even though the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) score alterations correspond to raising concerns about cognitive decline, Mini-Mental State Examination (MMSE) and selective reminding test (SRT) score improvements support metformin's role in improving specific cognitive domains. As such, metformin may exert differential impacts on various aspects of cognitive performance in these patients. However, the inconsistency and low quality of current evidence point toward the need for accurate research to elucidate whether metformin's cognitive effects are protective, neutral, or context-dependent based on patient profiles.
关于二甲双胍摄入量与认知功能变化之间的关联，已有相互矛盾的研究结果报道。我们试图对系统评价和荟萃分析进行综述，以阐明二甲双胍作为单一疗法或联合疗法在2型糖尿病（T2DM）患者认知功能改变中的作用，并确定证据的质量。为了查找英文撰写的综述，于2023年5月1日在PubMed、科学网、Scopus、Cochrane图书馆、Trip和谷歌学术上进行了文献检索。文献检索共找到2672条记录，其中10条被纳入研究。二甲双胍可能为2型糖尿病患者带来认知益处，因为有证据表明其可能改善记忆力并降低神经退行性疾病的风险。尽管阿尔茨海默病评估量表认知分量表（ADAS-Cog）评分的改变引发了对认知衰退的担忧，但简易精神状态检查表（MMSE）和选择性提醒测试（SRT）评分的改善支持了二甲双胍在改善特定认知领域方面的作用。因此，二甲双胍可能对这些患者认知功能的各个方面产生不同影响。然而，当前证据的不一致性和低质量表明，需要进行准确的研究，以阐明基于患者特征，二甲双胍的认知作用是具有保护作用、中性作用还是取决于具体情况。
