Association between Metformin Use and Coronary Artery Calcification in Type 2 Diabetic Patients
Association between Metformin Use and Coronary Artery Calcification in Type 2 Diabetic Patients
复制标题
二甲双胍使用与 2 型糖尿病患者冠状动脉钙化之间的关联
DOI：
10.1155/2019/9484717
复制
发表时间：
2019-01-01
影响因子：
4.3
通讯作者：
Xiang, Meixiang
中科院分区：
文献类型：
--
作者：
Lu, Yi;Wang, Yidong;Xiang, Meixiang
目的2型糖尿病（T2 DM）合并冠状动脉钙化（CAC）是心血管事件的独立危险因素。二甲双胍是一线抗糖尿病药物。我们的目的是调查二甲双胍使用与CAC之间的关系。方法对369例2型糖尿病患者进行横断面研究。收集患者的CAC评分、临床特征和抗糖尿病药物处方信息。使用倾向评分匹配（PSM）策略平衡二甲双胍和非二甲双胍使用者的基线参数。结果在符合纳入标准的369例受试者中，288例受试者在PSM后被纳入进一步分析。二甲双胍处方而非其他降糖药物与较低的CAC评分相关（OR [95% CI] = 0.55 [0.34-0.90]; P = 0.018）。进一步的多变量logistic回归分析表明，二甲双胍与CAC严重程度呈负相关（OR [95% CI] = 0.58 [0.34-0.99]; P = 0.048），与年龄、BMI、eGFR、性别、吸烟、糖尿病病程、高血压、他汀类药物处方和非二甲双胍降糖药物数量无关。亚组分析显示二甲双胍与吸烟者CAC评分之间存在显著相关性（OR [95% CI] = 0.38 [0.16-0.93]; P = 0.035），但在从不吸烟者中未观察到相关性（OR [95% CI] = 0.72 [0.34-1.51]; P = 0.383）。结论二甲双胍使用与T2 DM患者CAC评分降低独立相关。CAC评分与二甲双胍之间的负相关性在有吸烟史的患者中最为显著。
Objectives Type 2 diabetes mellitus (T2DM) is associated with coronary artery calcification (CAC) which is an independent risk factor for cardiovascular events. Metformin is the first-line antidiabetic medication. We aimed to investigate the association between metformin use and CAC. Methods We included 369 patients with T2DM in this cross-sectional study. CAC scores, clinical characteristics, and antidiabetic drug prescription information of the patients were acquired. Baseline parameters were balanced for metformin and nonmetformin users using the propensity score matching (PSM) strategy. Results Among the 369 subjects who met our inclusion criteria, 288 subjects were included for further analysis after PSM. Metformin prescription rather than other antidiabetic medications was related to lower CAC scores (OR [95% CI] = 0.55 [0.34–0.90]; P = 0.018). Further multivariable logistic regression analysis demonstrated that metformin was negatively associated with CAC severity (OR [95% CI] = 0.58 [0.34–0.99]; P = 0.048), which was independent of age, BMI, eGFR, gender, cigarette smoking, duration of diabetes, hypertension, statin prescription, and number of nonmetformin antidiabetic agents. A subgroup analysis revealed a significant association between metformin and CAC scores in smokers (OR [95% CI] = 0.38 [0.16–0.93]; P = 0.035), but the association was not observed in never-smokers (OR [95% CI] = 0.72 [0.34–1.51]; P = 0.383). Conclusions Metformin usage was independently associated with lower CAC scores in T2DM patients. The negative correlation between CAC scores and metformin was most prominent in patients with a history of cigarette smoking.