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Metformin in elderly type 2 diabetes mellitus: dose-dependent dementia risk reduction.
Sun, Mingyang; Chen, Wan-Ming; Wu, Szu-Yuan; Zhang, Jiaqiang.
Afiliação
  • Sun M; Department of Anesthesiology and Perioperative Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou 450052, China.
  • Chen WM; Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, Taipei 242, Taiwan.
  • Wu SY; Artificial Intelligence Development Center, Fu Jen Catholic University, Taipei 242, Taiwan.
  • Zhang J; Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, Taipei 242, Taiwan.
Brain ; 147(4): 1474-1482, 2024 Apr 04.
Article em En | MEDLINE | ID: mdl-37878862
This study aimed to investigate the controversial association between metformin use and diabetes-associated dementia in elderly patients with type 2 diabetes mellitus (T2DM) and evaluate the potential protective effects of metformin, as well as its intensity of use and dose-dependency, against dementia in this population. The study used a time-dependent Cox hazards model to evaluate the effect of metformin use on the incidence of dementia. The case group included elderly patients with T2DM (≥60 years old) who received metformin, while the control group consisted of elderly patients with T2DM who did not receive metformin during the follow-up period. Our analysis revealed a significant reduction in the risk of dementia among elderly individuals using metformin, with an adjusted hazard ratio of 0.34 (95% confidence interval: 0.33 to 0.36). Notably, metformin users with a daily intensity of 1 defined daily dose (DDD) or higher had a lower risk of dementia, with an adjusted hazard ratio (95% confidence interval) of 0.46 (0.22 to 0.6), compared to those with a daily intensity of <1 DDD. Additionally, the analysis of cumulative DDDs of metformin showed a dose-response relationship, with progressively lower adjusted hazard ratio across quartiles (0.15, 0.21, 0.28, and 0.53 for quartiles 4, 3, 2 and 1, respectively), compared to never metformin users (P for trend < 0.0001). Metformin use in elderly patients with T2DM is significantly associated with a substantial reduction in the risk of dementia. Notably, the protective effect of metformin demonstrates a dose-dependent relationship, with higher daily and cumulative dosages of metformin showing a greater risk reduction.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Demência / Diabetes Mellitus Tipo 2 / Metformina Limite: Aged / Humans / Middle aged Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Demência / Diabetes Mellitus Tipo 2 / Metformina Limite: Aged / Humans / Middle aged Idioma: En Ano de publicação: 2024 Tipo de documento: Article