The effect of metformin on culture conversion in tuberculosis patients with diabetes mellitus
The effect of metformin on culture conversion in tuberculosis patients with diabetes mellitus
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DOI：
10.3904/kjim.2017.249
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发表时间：
2018-09-01
影响因子：
2.4
通讯作者：
Heo, Eun Young
中科院分区：
文献类型：
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作者：
Lee, Ye-Jin;Han, Sung Koo;Heo, Eun Young
背景/目标：糖尿病（DM）和结核病（TB）患者的发病率增加，治疗失败或复发的风险很高。同时管理这两种疾病是很重要的。在抗糖尿病药物中，二甲双胍抑制分枝杆菌的细胞内生长。因此，我们研究了二甲双胍对结核病治疗的影响，特别是在DM患者中。方法：这项回顾性队列研究包括2011年至2012年诊断为培养阳性肺结核的患者。主要的研究结果是痰培养转换后2个月的treatment.Results：499例确诊为培养阳性肺TB，105（21%）在诊断糖尿病。其中，62例（59.5%）接受二甲双胍治疗。除存在慢性肾脏疾病外，二甲双胍组和非二甲双胍组的基线特征无显著差异。结核治疗完成后1年内，二甲双胍治疗对痰培养转化（p = 0.60）和复发（p = 0.39）无显著影响。二甲双胍可提高空洞型肺结核患者痰菌阴转率（优势比为10.8; 95%可信区间为1.22 ~ 95.63）。结论：在合并糖尿病的空洞型肺结核患者中，二甲双胍治疗2个月后可有效提高痰菌阴转率。
Background/Aims: Patients with diabetes mellitus (DM) and tuberculosis (TB) have increased morbidity and a high risk of treatment failure or recurrence. It is important to manage both diseases simultaneously. Among anti-diabetic drugs, metformin inhibits intracellular growth of mycobacteria. Therefore, we examined the effects of metformin on TB treatment, especially in patients with DM.Methods: This retrospective cohort study included patients with culture-positive pulmonary TB diagnosed between 2011 and 2012. The primary study outcome was sputum culture conversion after 2 months of treatment.Results: Of 499 patients diagnosed with culture-positive pulmonary TB, 105 (21%) had DM at diagnosis. Among them, 62 (59.5%) were treated with metformin. Baseline characteristics, except for the presence of chronic renal disease, were not significantly different between the metformin and non-metformin groups. Metformin treatment had no significant effect on sputum culture conversion (p = 0.60) and recurrence within 1 year after TB treatment completion (p = 0.39). However, metformin improved the sputum culture conversion rate in patients with cavitary pulmonary TB, who have higher bacterial loads (odds ratio, 10.8; 95% confidence interval, 1.22 to 95.63).Conclusions: Among cavitary pulmonary TB patients with DM, metformin can be an effective adjunctive anti-TB agent to improve sputum culture conversion after 2 months of treatment.