Metformin Is Associated With Improved Inflammatory Bowel Disease Outcomes in Patients With Type 2 Diabetes Mellitus: A Propensity-Matched Cohort Study.

IF 4.5 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Inflammatory Bowel Diseases Pub Date : 2025-05-12 DOI:10.1093/ibd/izae147

Jessica C Petrov, Aakash A Desai, Gursimran S Kochhar, Sheena K Crosby, Jami A Kinnucan, Michael F Picco, Jana G Hashash, Francis A Farraye

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Abstract

Background: Metformin exerts anti-inflammatory properties through a positive effect on oxidative stress, gut barrier integrity, and the gut microbiota. Our aim was to evaluate the influence of metformin on inflammatory bowel disease (IBD) outcomes in patients with type 2 diabetes mellitus (T2DM).

Methods: We conducted a retrospective cohort study using the TriNetX database in patients with IBD and T2DM who initiated metformin vs oral hypoglycemics or insulin (control cohort) between August 31, 2002, and August 31, 2022. One-to-one propensity score matching was performed. Primary outcomes were need for intravenous (IV) steroid use or IBD-related surgery within 1, 2, and 3 years after metformin initiation.

Results: Our cohorts included 1323 patients with ulcerative colitis (UC) (mean age 58.7 ± 12.2 years, 50.1% female, 77.3% White) and 1278 patients with Crohn's disease (CD) (mean age 56.3 ± 12.6 years, 58.2% female, 76.5% White). At 1 year, patients with UC and CD were less likely to require IV steroids (UC: adjusted odds ratio [aOR], 0.45; 95% confidence interval [CI], 0.34-0.59; P < .01; CD: aOR, 0.67; 95% CI, 0.53-0.85; P < .01). The decreased need for IV steroids persisted in all metformin groups at 2 and 3 years. Patients with CD were at a lower risk for IBD-related surgery at year 1 (aOR, 0.5; 95% CI, 0.31-0.81; P < .01), and this finding persisted at 3 years (aOR, 0.62; 95% CI, 0.43-0.89; P < .01). Metformin did not affect risk for surgery in patients with UC.

Conclusions: Patients with IBD and T2DM on metformin had a decreased likelihood of worse IBD outcomes.

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二甲双胍可改善 2 型糖尿病患者的炎症性肠病预后：倾向匹配队列研究

背景：二甲双胍通过对氧化应激、肠道屏障完整性和肠道微生物群产生积极影响来发挥抗炎作用。我们的目的是评估二甲双胍对 2 型糖尿病（T2DM）患者炎症性肠病（IBD）预后的影响：我们利用 TriNetX 数据库对 2002 年 8 月 31 日至 2022 年 8 月 31 日期间开始服用二甲双胍与口服降糖药或胰岛素的 IBD 和 T2DM 患者（对照队列）进行了一项回顾性队列研究。进行了一对一倾向评分匹配。主要结果是在服用二甲双胍后的 1、2 和 3 年内需要静脉注射类固醇或进行 IBD 相关手术：我们的队列包括 1323 名溃疡性结肠炎（UC）患者（平均年龄为 58.7 ± 12.2 岁，50.1% 为女性，77.3% 为白人）和 1278 名克罗恩病（CD）患者（平均年龄为 56.3 ± 12.6 岁，58.2% 为女性，76.5% 为白人）。1 年后，UC 和 CD 患者需要静脉注射类固醇的几率降低（UC：调整后的几率比 [aOR]，0.45；95% 置信区间 [CI]，0.34-0.59；P < .01；CD：aOR，0.67；95% CI，0.53-0.85；P < .01）。所有二甲双胍组患者在2年和3年内对静脉注射类固醇的需求均有所减少。CD 患者在第一年接受 IBD 相关手术的风险较低（aOR，0.5；95% CI，0.31-0.81；P < .01），这一结果在 3 年后依然存在（aOR，0.62；95% CI，0.43-0.89；P < .01）。二甲双胍不会影响UC患者的手术风险：结论：IBD和T2DM患者服用二甲双胍后，IBD病情恶化的可能性降低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Inflammatory Bowel Diseases 医学-胃肠肝病学

CiteScore

9.70

自引率

6.10%

发文量

462

审稿时长

1 months

期刊介绍： Inflammatory Bowel Diseases® supports the mission of the Crohn''s & Colitis Foundation by bringing the most impactful and cutting edge clinical topics and research findings related to inflammatory bowel diseases to clinicians and researchers working in IBD and related fields. The Journal is committed to publishing on innovative topics that influence the future of clinical care, treatment, and research.