Diabetes & metabolism最新文献

{"title":"Associations of type 2 diabetes and the risk of migraine in Chinese populations","authors":"Jielong Wu ,&nbsp;Jie Fang ,&nbsp;Xiaodong Yuan ,&nbsp;Lingshan Ma ,&nbsp;Liangcheng Zheng ,&nbsp;Qing Lin ,&nbsp;Xingkai An ,&nbsp;Zhanxiang Wang ,&nbsp;Qilin Ma","doi":"10.1016/j.diabet.2024.101518","DOIUrl":"10.1016/j.diabet.2024.101518","url":null,"abstract":"<div><h3>Aim</h3><p>We aimed to explore the relationship between type 2 diabetes mellitus (T2DM) and the incidence rate of migraine in a Chinese population, and analyze the clinical characteristics of migraine patients with T2DM.</p></div><div><h3>Methods</h3><p><span><span>Data on the study cohort of 9873 individuals were obtained from the China Health and Retirement Longitudinal Study (CHARLS). The incidence rate of migraine from 2015 to 2018 was assessed. The Cox </span>proportional hazards model was used to estimate hazard ratios (HRs) and their 95% confidence intervals (CIs) for the relationship between T2DM and the incidence of migraine. In addition, a cross-sectional study including 168 migraine patients was conducted in Xiamen, China. Migraine patients were grouped according to their T2DM status. Multivariable </span>linear regression models were used to estimate βs and their 95% CIs for the relationship between migraine characteristics and T2DM.</p></div><div><h3>Results</h3><p>The cumulative incidence rate of migraine from 2015 to 2018 in the T2DM group and control group was 7.26% [6.04%.8.65%] and 8.91% [8.27%.9.58%], respectively. The risk of migraine in patients with T2DM was reduced by 21% (HR 0.79 [0.65;0.95]) compared to patients with no T2DM after adjustment for confounders. The cross-sectional study showed that the presence of T2DM significantly reduced migraine frequency and relieved migraine intensity.</p></div><div><h3>Conclusion</h3><p>This was the first study to validate that T2DM reduced the risk of migraine in a Chinese population cohort. Patients with migraine and T2DM may experience significant relief from their headache symptoms. Carrying out relevant mechanistic research may help to identify new targets for migraine treatment<span> and contribute to further understanding the impact of T2DM or related metabolic disorders on an individual's health.</span></p></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"50 2","pages":"Article 101518"},"PeriodicalIF":7.2,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139560147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social isolation, loneliness, and the risk of incident type 2 diabetes mellitus by glycemic status","authors":"Yanjun Zhang ,&nbsp;Mengyi Liu ,&nbsp;Chun Zhou ,&nbsp;Ziliang Ye ,&nbsp;Yuanyuan Zhang ,&nbsp;Sisi Yang ,&nbsp;Panpan He ,&nbsp;Xiaoqin Gan ,&nbsp;Xianhui Qin","doi":"10.1016/j.diabet.2024.101517","DOIUrl":"10.1016/j.diabet.2024.101517","url":null,"abstract":"<div><h3>Aim</h3><p>The modifying effect of prediabetic status on the association of social isolation and loneliness with the risk of type 2 diabetes mellitus (T2DM) remains uncertain. We aimed to explore whether prediabetic status modifies the association of social isolation and loneliness with incident T2DM.</p></div><div><h3>Methods</h3><p><span>358,951 participants with random blood glucose &lt; 11.1 mmol/l, </span>hemoglobin A1c<span><span> &lt; 6.5 % and without diagnosis of diabetes from the UK Biobank were included. </span>Prediabetes was defined by hemoglobin A1c level at 5.7–6.4 %. Social isolation and loneliness were assessed using self-reported questionnaires. The study outcome was incident T2DM.</span></p></div><div><h3>Results</h3><p>During a median follow-up of 12.5 years, 13,213 (3.7 %) incident T2DM cases were documented. Social isolation and loneliness in subjects with normoglycemia (adjusted HR [95 %CI]: social isolation: 1.14 [1.07;1.23]; loneliness: 1.33 [1.20;1.47]) were more strongly associated with increased risk of T2DM than in those with prediabetes (adjusted HR [95 %CI]: social isolation: 0.97 [0.91;1.03]; loneliness: 1.04 [0.95;1.13]) (Both <em>P</em><span> for interaction &lt; 0.001). Among individuals with prediabetes, alcoholic consumption (30.9 %), household income (23.3 %), healthy sleep (17.1 %), loneliness (14.9 %), and physical activity (12.6 %) mediated most of the variance in the association between social isolation and incident T2DM, while body mass index (17.9 %) and healthy sleep (17.6 %) mediated most of the variance in the association between loneliness and incident T2DM.</span></p></div><div><h3>Conclusion</h3><p>Social isolation and loneliness were independently associated with a higher risk of T2DM among individuals without prediabetes. Among those with prediabetes, the association of social isolation and loneliness with incident T2DM were mainly mediated by some socioeconomic and lifestyle factors.</p></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"50 2","pages":"Article 101517"},"PeriodicalIF":7.2,"publicationDate":"2024-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139507803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hope, hype and present limitations of hybrid closed loop systems for persons with type 1 diabetes","authors":"Charles Thivolet","doi":"10.1016/j.diabet.2024.101510","DOIUrl":"10.1016/j.diabet.2024.101510","url":null,"abstract":"","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"50 2","pages":"Article 101510"},"PeriodicalIF":7.2,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139471226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eleven-year trends in socioeconomic inequalities in the prevalence and incidence of pharmacologically treated type 2 diabetes in France, 2010–2020","authors":"Marie Guion ,&nbsp;Laurence Mandereau-Bruno ,&nbsp;Sarah Goria ,&nbsp;Emmanuel Cosson ,&nbsp;Sandrine Fosse-Edorh","doi":"10.1016/j.diabet.2024.101509","DOIUrl":"10.1016/j.diabet.2024.101509","url":null,"abstract":"<div><h3>Aim</h3><p>This study aimed to describe the association between socioeconomic inequalities and the prevalence and incidence of pharmacologically-treated type 2 diabetes in European France over the 2010–2020 period.</p></div><div><h3>Methods</h3><p>Diabetes cases were identified using a validated algorithm from the French National Health Data System. Analysis was restricted to adults aged 45 years and older to focus on type 2 diabetes. Socioeconomic inequalities were measured for all years in European France using the French deprivation index (FDep, 2015 version), which is an area-based deprivation indicator using population-weighted quintiles (Q1 corresponds to the least deprived municipalities). The relative risks of diabetes prevalence and incidence associated with FDep quintiles (Q1 as the reference) were estimated by sex using a log-linear Poisson model adjusted for year, age and French department. The study population was the French health consumers aged 45 years and over (from 24,228,526 in 2010 to 29,772,928 in 2020).</p></div><div><h3>Results</h3><p>A positive gradient was observed in the relative risks of type 2 diabetes prevalence and incidence by FDep quintiles over the study period. The strength of the estimated associations increased over the last decade for prevalence among men and women and for incidence among men in the two most deprived quintiles.</p></div><div><h3>Conclusion</h3><p>Thus, type 2 diabetes prevention should include a proportionate universalism approach, proposing actions of greater intensity in the most deprived areas.</p></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"50 2","pages":"Article 101509"},"PeriodicalIF":7.2,"publicationDate":"2024-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139411692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased risk of incident mental disorders in adults with new-onset type 1 diabetes diagnosed after the age of 19: A nationwide cohort study","authors":"Seohyun Kim ,&nbsp;Gyuri Kim ,&nbsp;So Hyun Cho ,&nbsp;Rosa Oh ,&nbsp;Ji Yoon Kim ,&nbsp;You-Bin Lee ,&nbsp;Sang-Man Jin ,&nbsp;Kyu Yeon Hur ,&nbsp;Jae Hyeon Kim","doi":"10.1016/j.diabet.2023.101505","DOIUrl":"10.1016/j.diabet.2023.101505","url":null,"abstract":"<div><h3>Aim</h3><p>This population-based study aimed to investigate the risk of mental disorders in adults with new-onset type 1 diabetes mellitus compared to the general population without diabetes.</p></div><div><h3>Methods</h3><p>We selected 10,391 adults with new-onset type 1 diabetes and 51,995 adults in the general population without diabetes with a median follow-up of 7.94 years using the National Health Insurance Database in South Korea between January 2009 and December 2020. The adjusted hazard ratios (aHRs) were estimated for the occurrence of mental disorders.</p></div><div><h3>Results</h3><p>The incidence of mental disorders was more than twice as high in patients with new-onset type 1 diabetes (66 per 1000 person-years) than in those without diabetes (29 per 1000 person-years). The aHR [95 % confidence interval] comparing adults with new-onset type 1 diabetes with those without diabetes were 2.20 [2.12.2.29] for mental disorders, 3.16 [2.99.3.35], for depression, 2.55 [2.32.2.80] for mood disorders, 1.89 [1.80.1.97] for anxiety and stress related disorders, 2.50 [1.48.4.22] for eating disorders, 2.62 [1.45.4.73] for personality and behavior disorders and 4.39 [3.55.5.43] for alcohol and drug misuse disorders. When new-onset type 1 diabetes occurred at the age of 41 to 50, the aHR of developing mental illness was 2.43 [2.19.2.70], compared to those without diabetes.</p></div><div><h3>Conclusions</h3><p>In this nationwide prospective study, new-onset type 1 diabetes in adulthood was significantly associated with a higher risk of mental disorders than in the general population without diabetes.</p></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"50 1","pages":"Article 101505"},"PeriodicalIF":7.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138682408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"French National Authority for Health assessment of metabolic surgery for type 2 diabetes remission—A meta-analysis in patients with class I to III obesity","authors":"Jean-Charles Lafarge ,&nbsp;Judith Aron-Wisnewsky ,&nbsp;François Pattou ,&nbsp;Michel Cucherat ,&nbsp;Emmanuelle Blondet ,&nbsp;Sylvie Lascols ,&nbsp;ARMMS-T2D Consortium ,&nbsp;Dominique Le Guludec ,&nbsp;Denis-Jean David ,&nbsp;Cédric Carbonneil","doi":"10.1016/j.diabet.2023.101495","DOIUrl":"10.1016/j.diabet.2023.101495","url":null,"abstract":"<div><h3>Objective</h3><p>Randomized controlled trials (RCTs) have demonstrated the superiority of metabolic surgery (MS) over medical therapy (MT) in patients with obesity and type 2 diabetes, leading, to a joint statement in 2016 proposing MS to patients with class I obesity and uncontrolled glycemia. Yet, these RCTs included few patients with class I obesity (body mass index 30–35 kg/m²) and even fewer patients with overweight. Our aim was to provide an updated systematic review (SR) with meta-analysis (MA) of RCTs reporting diabetes remission (DR) after MS in these patients.</p></div><div><h3>Research design and methods</h3><p>We included in the SR with MA only RCTs with at least 24-month follow-up found in Medline, Cochrane Library, Embase, and LiSSA between January 2008 and September 2022 comparing DR post-MT versus post-MS. We calculated relative risk (RR) and 95 % confidence intervals (CIs) using the Mantel-Haenszel random-effects approach to examine differences in DR between patients allocated to MS versus MT.</p></div><div><h3>Results</h3><p>DR was significantly higher in MS versus MT after 36 months’ follow-up in patients with obesity (RR = 6.65 [95 %CI 2.24;19.79]; I² = 27 %; 5 trials, 404 patients), but also specifically in patients with class I obesity (RR = 5.27 [1.31;21.23]; I² = 0 %; 4 trials, 80 patients). Furthermore, and in line with previous results, all additional MAs performed in patients with obesity in this work favor MS (specifically Roux-en-Y gastric bypass) over MT at 24, 36 (only) and 60 months of follow-up.</p></div><div><h3>Conclusions</h3><p>Although the data available in patients with class I obesity and type 2 diabetes remains limited, MA shows higher rates of DR after MS compared with MT after 36 months’ follow-up in these patients. Consequently, the French National Authority for Health French (<em>HAS)</em> recommends MS for these patients.</p></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"50 1","pages":"Article 101495"},"PeriodicalIF":7.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1262363623000770/pdfft?md5=6727d03e96cec6df248ed395eaa5d335&pid=1-s2.0-S1262363623000770-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138435581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dominant PDX1 deficiency causes highly penetrant diabetes at different ages, associated with obesity and exocrine pancreatic deficiency: Lessons for precision medicine","authors":"Youssef Kouidrat ,&nbsp;Lauriane Le Collen ,&nbsp;Martine Vaxillaire ,&nbsp;Aurélie Dechaume ,&nbsp;Bénédicte Toussaint ,&nbsp;Emmanuel Vaillant ,&nbsp;Souhila Amanzougarene ,&nbsp;Mehdi Derhourhi ,&nbsp;Brigitte Delemer ,&nbsp;Mustapha Azahaf ,&nbsp;Philippe Froguel ,&nbsp;Amélie Bonnefond","doi":"10.1016/j.diabet.2023.101507","DOIUrl":"10.1016/j.diabet.2023.101507","url":null,"abstract":"<div><h3>Objective</h3><p>Heterozygous pathogenic or likely pathogenic (P/LP) <em>PDX1</em> variants cause monogenic diabetes. We comprehensively examined the phenotypes of carriers of P/LP <em>PDX1</em><span> variants, and delineated potential treatments that could be efficient in an objective of precision medicine.</span></p></div><div><h3>Methods</h3><p>The study primarily involved a family harboring a novel P/LP <em>PDX1</em> variant. We then conducted an analysis of documented carriers of P/LP <em>PDX1</em><span> variants, from the Human Gene Mutation Database (HGMD), RaDiO study, and Type 2 Diabetes Knowledge Portal (T2DKP) including 87 K participants.</span></p></div><div><h3>Results</h3><p>Within the family, we identified a P/LP <em>PDX1</em><span> variant encoding p.G232S in four relatives. All of them exhibited diabetes, albeit with very different ages of onset (10–40 years), along with caudal pancreatic agenesis and childhood-onset obesity. In the HGMD, 79 % of carriers of a P/LP </span><em>PDX1</em><span> variant displayed diabetes (with differing ages of onset from eight days of life to 67 years), 63 % exhibited pancreatic insufficiency and surprisingly 40 % had obesity. The impact of P/LP </span><em>PDX1</em><span> variants on increased risk of type 2 diabetes mellitus was confirmed in the T2DKP. Dipeptidyl peptidase 4 inhibitor (DPP4i) and glucagon-like peptide-1 receptor agonist (GLP1-RA), enabled good glucose control without hypoglycemia and weight management.</span></p></div><div><h3>Conclusions</h3><p>This study reveals diverse clinical presentations among the carriers of a P/LP <em>PDX1</em><span> variant, highlighting strong variations in diabetes onset, and unexpectedly high prevalence of obesity and pancreatic development abnormalities. Clinical data suggest that DPP4i and GLP1-RA may be the best effective treatments to manage both glucose and weight controls, opening new avenue in precision diabetic medicine.</span></p></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"50 1","pages":"Article 101507"},"PeriodicalIF":7.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138992235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Steatotic liver disease, MASLD and risk of chronic kidney disease","authors":"Josh Bilson ,&nbsp;Alessandro Mantovani ,&nbsp;Christopher D. Byrne ,&nbsp;Giovanni Targher","doi":"10.1016/j.diabet.2023.101506","DOIUrl":"10.1016/j.diabet.2023.101506","url":null,"abstract":"<div><p>With the rising tide of fatty liver disease related to metabolic dysfunction worldwide, the association of this common liver disease with chronic kidney disease (CKD) has become increasingly evident. In 2020, the more inclusive term metabolic dysfunction-associated fatty liver disease (MAFLD) was proposed to replace the old term non-alcoholic fatty liver disease (NAFLD). In 2023, a modified Delphi process was led by three large pan-national liver associations. There was consensus to change the fatty liver disease nomenclature and definition to include the presence of at least one of five common cardiometabolic risk factors as diagnostic criteria. The name chosen to replace NAFLD was metabolic dysfunction-associated steatotic liver disease (MASLD). The change of nomenclature from NAFLD to MAFLD and then MASLD has resulted in a reappraisal of the epidemiological trends and associations with the risk of developing CKD. The observed association between MAFLD/MASLD and CKD and our understanding that CKD can be an epiphenomenon linked to underlying metabolic dysfunction support the notion that individuals with MASLD are at substantially higher risk of incident CKD than those without MASLD. This narrative review provides an overview of the literature on (a) the evolution of criteria for diagnosing this highly prevalent metabolic liver disease, (b) the epidemiological evidence linking MASLD to the risk of CKD, (c) the underlying mechanisms by which MASLD (and factors strongly linked with MASLD) may increase the risk of developing CKD, and (d) the potential drug treatments that may benefit both MASLD and CKD.</p></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"50 1","pages":"Article 101506"},"PeriodicalIF":7.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1262363623000885/pdfft?md5=7808744e3012e3315d1b4f7e47dfe2d6&pid=1-s2.0-S1262363623000885-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139028920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular protection significantly depends on HbA1c improvement with GLP-1RAs but not with SGLT2 is in type 2 diabetes: A narrative review","authors":"André J. Scheen","doi":"10.1016/j.diabet.2023.101508","DOIUrl":"10.1016/j.diabet.2023.101508","url":null,"abstract":"<div><h3>Background</h3><p>Glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter 2 inhibitors (SGLT2is), while developed as antihyperglycaemic medications for the treatment of type 2 diabetes, have proven to reduce major cardiovascular adverse events (MACEs) and hospitalization for heart failure (especially for SGLT2is) in dedicated cardiovascular outcome trials. The contribution of the glucose-lowering effect in the cardiovascular protection is uncertain and may differ between the two drug classes.</p></div><div><h3>Methods</h3><p>This narrative review compares the relative effects of glycated hemoglobin (HbA1c) reduction on the cardiovascular protection provided by GLP-1RAs and SGLT2is in placebo-controlled cardiovascular outcome trials by using the results of either post-hoc mediation analyses or meta-regression studies.</p></div><div><h3>Results</h3><p>Both mediation and meta-regression analyses suggest that the lower cardiovascular risk with GLP-1RAs partially but substantially tracks with their glucose-lowering effect, especially when considering the reduction in nonfatal strokes. In contrast, similar analyses fail to demonstrate any significant contribution of the glucose-lowering effect with SGLT2is, not only on MACEs but also on heart failure issues.</p></div><div><h3>Conclusion</h3><p>The contribution of improved glucose control in cardiovascular protection is limited, but is much greater for GLP-1RAs than for SGLT2is. Of note, such mediation or meta-regression analyses are exploratory and can only be viewed as hypothesis generating.</p></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"50 2","pages":"Article 101508"},"PeriodicalIF":7.2,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139057648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metformin treatment is associated with improved survival in diabetic patients hospitalized with acute heart failure: A prospective observational study using the Korean acute heart failure registry data","authors":"Kyeong-Hyeon Chun ,&nbsp;Jaewon Oh ,&nbsp;Chan Joo Lee ,&nbsp;Jin Joo Park ,&nbsp;Sang Eun Lee ,&nbsp;Min-Seok Kim ,&nbsp;Hyun-Jai Cho ,&nbsp;Jin-Oh Choi ,&nbsp;Hae-Young Lee ,&nbsp;Kyung-Kuk Hwang ,&nbsp;Kye Hun Kim ,&nbsp;Byung-Su Yoo ,&nbsp;Dong-Ju Choi ,&nbsp;Sang Hong Baek ,&nbsp;Eun-Seok Jeon ,&nbsp;Jae-Joong Kim ,&nbsp;Myeong-Chan Cho ,&nbsp;Shung Chull Chae ,&nbsp;Byung-Hee Oh ,&nbsp;Seok-Min Kang","doi":"10.1016/j.diabet.2023.101504","DOIUrl":"10.1016/j.diabet.2023.101504","url":null,"abstract":"<div><h3>Aims</h3><p>Although the hypothesis that metformin<span> is beneficial for patients with diabetes and heart failure (HF) has been steadily raised, there is limited data on metformin use in patients<span> with acute HF. We analyzed the association of metformin on all-cause mortality in hospitalized patients with type 2 diabetes and acute HF.</span></span></p></div><div><h3>Methods</h3><p><span>The Korean Acute Heart Failure registry prospectively enrolled patients hospitalized for acute HF from 2011 to 2014. Among this cohort, we analyzed patients with diabetes with baseline estimated glomerular filtration rate (eGFR) of 30 ml/min/1.73 m</span>²<span> or more. We analyzed the all-cause mortality and re-hospitalization for HF within 1 year after discharge<span>. Inverse probability treatment weighting method was used to adjust baseline differences on metformin treatment.</span></span></p></div><div><h3>Results</h3><p>The study analyzed data from 1,309 patients with HF and diabetes (mean age 69 years, 56 % male). Among them, 613 (47 %) patients were on metformin at admission. During the median follow-up period of 11 months, 132 (19 %) and 74 (12 %) patients not receiving and receiving metformin treatment died, respectively. The mortality rate was lower in metformin users than in non-users (hazard ratio 0.616 [0.464–0.819] <em>P</em>&lt;0.001). After adjustment, metformin was significantly associated with a lower risk for the mortality (hazard ratio 0.677 [0.495–0.928] <em>P</em>=0.015). In subgroup analyses, this association remains significant irrespective of baseline kidney function (eGFR &lt;60 or ≥60 ml/min/1.73 m², <em>P</em><span>-for-interaction=0.176) or left ventricular ejection fraction (&lt;40 %, 40–49 %, or ≥50 %, </span><em>P</em>-for-interaction=0.224).</p></div><div><h3>Conclusions</h3><p>Metformin treatment at the time of admission was associated with a lower risk for 1-year mortality in patients with diabetes, hospitalized for acute HF.</p></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"50 1","pages":"Article 101504"},"PeriodicalIF":7.2,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138572627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}