{"title":"二甲双胍与2型糖尿病患者痴呆风险的关联：一项系统综述和荟萃分析","authors":"Chunbian Tang, Jiayi Hao, Fengran Tao, Qingguo Feng, Ying Song, Baoqi Zeng","doi":"10.1111/dom.16192","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>There is ongoing debate concerning the association of metformin with the risk of dementia in type 2 diabetes mellitus (T2DM). This study was conducted to evaluate the impact of metformin therapy on dementia in patients with T2DM.</p><p><strong>Materials and methods: </strong>PubMed, Embase, Cochrane Library, Web of Science and the ClinicalTrials.gov website were searched until 9 April 2024. Cohort studies investigating the effects of metformin therapy compared with other antidiabetic drugs or no therapy in T2DM were included. The hazard ratio (HR) and the 95% confidence interval (CI) were computed using the random effects model.</p><p><strong>Results: </strong>Twenty cohort studies (24 individual comparisons) involving 3 463 100 participants were identified. A meta-analysis revealed that people with T2DM who take metformin are linked to a lower incidence of all-cause dementia compared to non-user (n = 17, HR = 0.76, 95% CI = 0.65-0.91, p = 0.002, I<sup>2</sup> = 98.9%) and sulfonylureas (n = 5, HR = 0.88, 95% CI = 0.85-0.90, p < 0.001, I<sup>2</sup> = 9.7%), but not to thiazolidinedione (n = 2, HR = 0.53, 95% CI = 0.08-3.41, p = 0.503, I<sup>2</sup> = 92.7%). Additionally, metformin showed favourable effects in non-specified T2DM (n = 19, HR = 0.75, 95% CI = 0.64-0.89), but not in newly diagnosed T2DM (n = 5, HR = 1.01, 95% CI = 0.81-1.27).</p><p><strong>Conclusion: </strong>Metformin might correlate with a lower dementia incidence in people with T2DM. However, it is crucial to interpret these results with caution considering the high heterogeneity.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4000,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Association of Metformin use with risk of dementia in patients with type 2 diabetes: A systematic review and meta-analysis.\",\"authors\":\"Chunbian Tang, Jiayi Hao, Fengran Tao, Qingguo Feng, Ying Song, Baoqi Zeng\",\"doi\":\"10.1111/dom.16192\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aim: </strong>There is ongoing debate concerning the association of metformin with the risk of dementia in type 2 diabetes mellitus (T2DM). This study was conducted to evaluate the impact of metformin therapy on dementia in patients with T2DM.</p><p><strong>Materials and methods: </strong>PubMed, Embase, Cochrane Library, Web of Science and the ClinicalTrials.gov website were searched until 9 April 2024. Cohort studies investigating the effects of metformin therapy compared with other antidiabetic drugs or no therapy in T2DM were included. The hazard ratio (HR) and the 95% confidence interval (CI) were computed using the random effects model.</p><p><strong>Results: </strong>Twenty cohort studies (24 individual comparisons) involving 3 463 100 participants were identified. A meta-analysis revealed that people with T2DM who take metformin are linked to a lower incidence of all-cause dementia compared to non-user (n = 17, HR = 0.76, 95% CI = 0.65-0.91, p = 0.002, I<sup>2</sup> = 98.9%) and sulfonylureas (n = 5, HR = 0.88, 95% CI = 0.85-0.90, p < 0.001, I<sup>2</sup> = 9.7%), but not to thiazolidinedione (n = 2, HR = 0.53, 95% CI = 0.08-3.41, p = 0.503, I<sup>2</sup> = 92.7%). Additionally, metformin showed favourable effects in non-specified T2DM (n = 19, HR = 0.75, 95% CI = 0.64-0.89), but not in newly diagnosed T2DM (n = 5, HR = 1.01, 95% CI = 0.81-1.27).</p><p><strong>Conclusion: </strong>Metformin might correlate with a lower dementia incidence in people with T2DM. 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引用次数: 0
摘要
目的：关于二甲双胍与2型糖尿病（T2DM）痴呆风险的关系，一直存在争议。本研究旨在评估二甲双胍治疗对T2DM患者痴呆的影响。材料和方法：PubMed， Embase, Cochrane Library， Web of Science和ClinicalTrials.gov网站检索至2024年4月9日。研究了二甲双胍治疗与其他降糖药物或未治疗T2DM的效果的队列研究。采用随机效应模型计算风险比（HR）和95%置信区间（CI）。结果：共纳入20项队列研究（24项个体比较），共纳入3 463 100名受试者。一项荟萃分析显示，与未服用二甲双胍的T2DM患者相比（n = 17, HR = 0.76, 95% CI = 0.65-0.91, p = 0.002, I2 = 98.9%）和磺脲类药物（n = 5, HR = 0.88, 95% CI = 0.85-0.90, p = 9.7%），但与噻唑烷二酮（n = 2, HR = 0.53, 95% CI = 0.08-3.41, p = 0.503, I2 = 92.7%）相比，服用二甲双胍的T2DM患者的全因痴呆发病率较低。此外，二甲双胍对非特征性T2DM有良好的疗效（n = 19, HR = 0.75, 95% CI = 0.64-0.89），但对新诊断的T2DM无效（n = 5, HR = 1.01, 95% CI = 0.81-1.27）。结论：二甲双胍可能与T2DM患者痴呆发生率降低有关。然而，考虑到高异质性，谨慎解释这些结果是至关重要的。
Association of Metformin use with risk of dementia in patients with type 2 diabetes: A systematic review and meta-analysis.
Aim: There is ongoing debate concerning the association of metformin with the risk of dementia in type 2 diabetes mellitus (T2DM). This study was conducted to evaluate the impact of metformin therapy on dementia in patients with T2DM.
Materials and methods: PubMed, Embase, Cochrane Library, Web of Science and the ClinicalTrials.gov website were searched until 9 April 2024. Cohort studies investigating the effects of metformin therapy compared with other antidiabetic drugs or no therapy in T2DM were included. The hazard ratio (HR) and the 95% confidence interval (CI) were computed using the random effects model.
Results: Twenty cohort studies (24 individual comparisons) involving 3 463 100 participants were identified. A meta-analysis revealed that people with T2DM who take metformin are linked to a lower incidence of all-cause dementia compared to non-user (n = 17, HR = 0.76, 95% CI = 0.65-0.91, p = 0.002, I2 = 98.9%) and sulfonylureas (n = 5, HR = 0.88, 95% CI = 0.85-0.90, p < 0.001, I2 = 9.7%), but not to thiazolidinedione (n = 2, HR = 0.53, 95% CI = 0.08-3.41, p = 0.503, I2 = 92.7%). Additionally, metformin showed favourable effects in non-specified T2DM (n = 19, HR = 0.75, 95% CI = 0.64-0.89), but not in newly diagnosed T2DM (n = 5, HR = 1.01, 95% CI = 0.81-1.27).
Conclusion: Metformin might correlate with a lower dementia incidence in people with T2DM. However, it is crucial to interpret these results with caution considering the high heterogeneity.
期刊介绍：
Diabetes, Obesity and Metabolism is primarily a journal of clinical and experimental pharmacology and therapeutics covering the interrelated areas of diabetes, obesity and metabolism. The journal prioritises high-quality original research that reports on the effects of new or existing therapies, including dietary, exercise and lifestyle (non-pharmacological) interventions, in any aspect of metabolic and endocrine disease, either in humans or animal and cellular systems. ‘Metabolism’ may relate to lipids, bone and drug metabolism, or broader aspects of endocrine dysfunction. Preclinical pharmacology, pharmacokinetic studies, meta-analyses and those addressing drug safety and tolerability are also highly suitable for publication in this journal. Original research may be published as a main paper or as a research letter.
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