» Articles » PMID: 39190051

The Impact of Metformin on Mortality in Patients with Type 2 Diabetes Mellitus: a Prospective Cohort Study

Overview
Journal Endocrine
Specialty Endocrinology
Date 2024 Aug 27
PMID 39190051
Authors
Affiliations
Soon will be listed here.
Abstract

Background: Metformin, a widely used antihyperglycemic drug, has shown efficacy in treating type 2 diabetes mellitus (T2DM) and is associated with potential benefits beyond glycemic control. This study investigates the impact of metformin on mortality in T2DM patients using a prospective cohort design utilizing data from the National Health and Nutrition Examination Survey (NHANES).

Methods: In NHANES 1999-2014, a total of 5813 representative participants aged 20 and above with T2DM were included in the analysis. We utilized Kaplan-Meier survival curves and multivariate Cox regression analysis to investigate the impact of metformin on both all-cause mortality and cause-specific mortality among patients with T2DM.

Results: Kaplan-Meier analysis showed a significant reduction in all-cause and cause-specific mortality in metformin users compared to non-users (p < 0.05). Multivariate Cox regression confirmed these findings, indicating that metformin use was associated with a 18% reduction in all-cause mortality (HR = 0.82, 95% CI = 0.73-0.92, p < 0.001) and 25% reduction in cardiovascular mortality (HR = 0.75, 95% CI = 0.60-0.94, p = 0.01).

Conclusion: Our results suggest that metformin significantly reduces all-cause and cardiovascular mortality in T2DM patients, highlighting its potential benefits beyond glycemic control. These results contribute to the existing literature by providing robust evidence from a large prospective cohort study. However, further research is needed to validate these findings and elucidate the underlying mechanisms controlling the effects of metformin on mortality outcomes in individuals with T2DM.

References
1.
Bailey C . Metformin: historical overview. Diabetologia. 2017; 60(9):1566-1576. DOI: 10.1007/s00125-017-4318-z. View

2.
Tobar N, Rocha G, Santos A, Guadagnini D, Assalin H, Camargo J . Metformin acts in the gut and induces gut-liver crosstalk. Proc Natl Acad Sci U S A. 2023; 120(4):e2211933120. PMC: 9942892. DOI: 10.1073/pnas.2211933120. View

3.
Karlsson F, Tremaroli V, Nookaew I, Bergstrom G, Behre C, Fagerberg B . Gut metagenome in European women with normal, impaired and diabetic glucose control. Nature. 2013; 498(7452):99-103. DOI: 10.1038/nature12198. View

4.
de Maranon A, Diaz-Pozo P, Canet F, Diaz-Morales N, Abad-Jimenez Z, Lopez-Domenech S . Metformin modulates mitochondrial function and mitophagy in peripheral blood mononuclear cells from type 2 diabetic patients. Redox Biol. 2022; 53:102342. PMC: 9124713. DOI: 10.1016/j.redox.2022.102342. View

5.
Stratton I, Adler A, Neil H, Matthews D, Manley S, Cull C . Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000; 321(7258):405-12. PMC: 27454. DOI: 10.1136/bmj.321.7258.405. View