Metformin Use and Risk of Asthma Exacerbation Among Asthma Patients with Glycemic Dysfunction.
Metformin Use and Risk of Asthma Exacerbation Among Asthma Patients with Glycemic Dysfunction.
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DOI：
10.1016/j.jaip.2021.07.007
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发表时间：
2021-11
期刊：
影响因子：
--
通讯作者：
McCormack MC
中科院分区：
文献类型：
--
作者：
Wu TD;Fawzy A;Akenroye A;Keet C;Hansel NN;McCormack MC
糖尿病与更严重的哮喘发病率相关。治疗糖尿病的二甲双胍可能在哮喘和血糖功能障碍患者中发挥作用。确定糖尿病患者使用二甲双胍与哮喘恶化之间的关联。我们查询了 2013 年 4 月 1 日至 2018 年 5 月 31 日期间约翰·霍普金斯大学的 EHR。对患有哮喘和糖尿病的成人进行了跟踪，从第一次糖化血红蛋白 (HbA1c) 测试到哮喘相关的全身皮质类固醇处方、急诊室 (ED) 就诊或住院治疗。多变量 Cox 模型估计与二甲双胍使用相关的每个结果的时间，建模为时间不变（HbA1c 测试状态）或时间依赖性（基于填充数据）。评估了 HbA1c 对结果的调节。通过倾向评分匹配进行敏感性分析。该队列由 1,749 名患有哮喘和糖尿病的成年人组成。入组时使用二甲双胍与哮喘相关急诊就诊风险较低相关（调整后风险比 [aHR] 0.40，95% 置信区间 [CI] 0.22-0.75），但与类固醇处方（aHR 0.89；95% CI 0.70-1.13）或住院（aHR 0.38，95% CI 0.13-1.12）无关。 HbA1c 不介导与急诊就诊的关联。由于二甲双胍暴露时间依赖性，二甲双胍的使用还与哮喘相关住院风险降低相关（aHR 0.30，95% CI 0.09-0.93）。在 698 名二甲双胍使用者与非使用者按倾向评分 1:1 匹配的子队列中，结果是一致的。与血糖控制和肥胖无关，二甲双胍的使用与哮喘相关急诊就诊和住院的风险较低有关。二甲双胍可能对哮喘和血糖功能障碍患者有益。
Diabetes is associated with worse asthma morbidity. Metformin, which treats diabetes, may have a role among patients with asthma and glycemic dysfunction. To determine the association between metformin use and asthma exacerbations among patients with diabetes. We queried the Johns Hopkins EHR from April 1, 2013 to May 31, 2018. Adults with asthma and diabetes were followed from first hemoglobin A1c (HbA1c) test to an asthma-related systemic corticosteroid prescription, emergency department (ED) visit, or hospitalization. Multivariable Cox models estimated time to each outcome associated with metformin use, modeled as either time-invariant (status at HbA1c testing) or time-dependent (based on fill data). Mediation of results by HbA1c was assessed. Sensitivity analysis was performed by propensity score matching. The cohort comprised of 1,749 adults with asthma and diabetes. Metformin use at entry was associated with a lower hazard of asthma-related ED visits (adjusted hazard ratio [aHR] 0.40, 95% confidence interval [CI] 0.22–0.75) but not steroid prescription (aHR 0.89; 95% CI 0.70–1.13) or hospitalization (aHR 0.38, 95% CI 0.13–1.12). HbA1c did not mediate the association with ED visits. With metformin exposure modeled as time-dependent, metformin use was additionally associated with lower hazard of asthma-related hospitalization (aHR 0.30, 95% CI 0.09–0.93). Results were consistent within a sub-cohort of 698 metformin users matched 1:1 to non-users by propensity score. Metformin use, independent of glycemic control and obesity, was associated with lower hazard of asthma-related ED visits and hospitalizations. Metformin may have benefit in patients with asthma and glycemic dysfunction.
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DOI：
10.1186/1710-1492-10-34
发表时间：
2014
期刊：
Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology
影响因子：
--
作者：
Rinne ST;Feemster LC;Collins BF;Au DH;Perkins M;Bryson CL;O'Riordan TG;Liu CF
通讯作者：
Liu CF
DOI：
10.1093/jamia/ocx071
发表时间：
2017-11-01
影响因子：
6.4
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Mandl, Kenneth D.
影响因子：
5.5
作者：
Travers, Debbie;Lich, Kristen Hassmiller;Waller, Anna
通讯作者：
Waller, Anna
DOI：
10.1164/rccm.201909-1813oc
发表时间：
2020-10-01
影响因子：
24.7
作者：
Peters, Michael C.;Mauger, David;Denlinger, Loren C.
通讯作者：
Denlinger, Loren C.
DOI：
10.2174/1871530315666150316124019
发表时间：
2015-01-01
影响因子：
1.9
作者：
Saisho, Yoshifumi
通讯作者：
Saisho, Yoshifumi