Association Between Preadmission Metformin Use and Outcomes in Intensive Care Unit Patients With Sepsis and Type 2 Diabetes: A Cohort Study

Yang, Qilin; Zheng, Jiezhao; Chen, Weiyan; Chen, Xiaohua; Wen, Deliang; Chen, Weixiao; Xiong, Xuming; Zhang, Zhenhui

doi:10.3389/fmed.2021.640785

Cited by 96 publications

(79 citation statements)

References 33 publications

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“…This may explain the results in the previous study ( 32 ) that the plasma concentration of lactic acid in surviving patients was higher than that in dying patients. Reciprocally, in our study, creatinine and lactate concentrations were not significantly different in patients with and without metformin ( 14 – 18 , 21 , 22 ). Additionally, increasing evidence was provided to show that metformin could ameliorate the autophagy and mitochondrial function of T-cells ( 33 ) and improve the systematic inflammation via decreased pro-inflammatory factors, such as NF-κB and tumor necrosis factor alpha (TNF-α) ( 34 ).…”

Section: Discussionsupporting

confidence: 60%

“…The eligible studies were observational studies that included septic patients with DM who used preadmission metformin. Furthermore, three articles ( 16 , 17 , 21 ) showed 28 day mortality, four studies ( 18 , 19 , 22 , 23 ) reported 30 day mortality, and four studies ( 14 , 15 , 24 , 25 ) reported in-hospital mortality. The primary outcome data were extracted.…”

Section: Resultsmentioning

confidence: 99%

“…The recent large sample study ( 19 ) showed that preadmission metformin use was not significantly related to the risk of sepsis and 30-d mortality of septic patients with DM. Comparatively, the latest study ( 22 ) indicated that preadmission metformin use was associated with a 39% decrease in 30-d mortality in septic patients with DM. Therefore, the conclusions still exist in controversy among the available articles.…”

Section: Discussionmentioning

confidence: 99%

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Association of Preadmission Metformin Use and Prognosis in Patients With Sepsis and Diabetes Mellitus: A Systematic Review and Meta-Analysis

Zhao

Guo

et al. 2021

Front. Endocrinol.

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Background and AimA growing body of evidence suggests that preadmission metformin use could decrease the mortality of septic patients with diabetes mellitus (DM); however, the findings remain controversial. Therefore, this meta-analysis was conducted on available studies to confirm the relationship between preadmission metformin use and mortality in patients with sepsis and DM.MethodsA comprehensive search of the PubMed, Embase, and Cochrane Library databases was performed for studies published before August 8, 2021. Observational studies assessing the correlation between metformin use and mortality in patients with sepsis and DM were considered eligible studies. We used the Newcastle–Ottawa Scale (NOS) to assess the outcome quality of each included article. Furthermore, the odds ratios (ORs) and 95% confidence intervals (CIs) were analyzed using the inverse variance method with random effects modeling.ResultsEleven articles including 8195 patients were analyzed in this meta-analysis. All the included articles were scored as low risk of bias. Our results showed that preadmission metformin use had a lower mortality rate (OR, 0.74; 95% CIs, 0.62–0.88, P < 0.01) in patients with sepsis and DM. Surprisingly, there was no statistically significant difference in the levels of serum creatinine (weighted mean difference (WMD), 0.36; 95% CIs, −0.03–0.75; P = 0.84) and lactic acid (WMD, −0.16; 95% CIs, −0.49–0.18; P = 0.07) between preadmission metformin use and non-metformin use.ConclusionsThis study is the most comprehensive meta-analysis at present, which shows that preadmission metformin use may reduce mortality and not increase the levels of serum creatinine and lactic acid in adult patients with sepsis and DM. Therefore, these data suggest that the potential efficacy of metformin could be assessed in future clinical studies.Systematic Review Registrationhttps://inplasy.com/?s=INPLASY2021100113, identifier INPLASY2021100113.

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Section: Discussionsupporting

confidence: 60%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Association of Preadmission Metformin Use and Prognosis in Patients With Sepsis and Diabetes Mellitus: A Systematic Review and Meta-Analysis

Zhao

Guo

et al. 2021

Front. Endocrinol.

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“…All the analyses were conducted using the statistical software packages R (http://www.R-project.org, The R Foundation) and Free Statistics software version 1.3 [15]. The complex multistage strati ed sampling design of NHANES was illustrated by the use of appropriate strata, clusters, and weights in the statistical analysis process.…”

Section: Discussionmentioning

confidence: 99%

Dietary Magnesium Intake Modifies the Association Between Vitamin D and Systolic Blood Pressure: Results From NHANES 2007-2014.

Huang

Zheng

et al. 2021

Preprint

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IntroductionAlthough the association between blood pressure and vitamin D has been well studied, the effects of dietary magnesium intake on this relationship are still unclear. Thus, this study aimed to determine the effects of dietary magnesium intake on the association between vitamin D and blood pressure.Research design and methodsThe present study analyzed data from the continuous NHANES 2007-2014. We included 8799 participants aged 20 years or older. Multivariable linear regression was performed to assess the association between vitamin D and systolic blood pressure (SBP), diastolic blood pressure (DBP). Dietary magnesium intake was stratified by low magnesium intake (<299mg/d), high magnesium intake (>=299mg/d). Effect modification by dietary magnesium intake was assessed through interaction tests between vitamin D and SBP in the multivariable linear regression.ResultsIn this cross-sectional study, we found vitamin D was negatively related to SBP, but not to DBP. The relationship between vitamin D and SBP was different in the low and high magnesium intake group (β: -0.18 95%Cl: -0.35-0 vs β: -0.3 95%Cl: -0.51- -0.1). Furthermore, magnesium intake significantly modified the negative relationship between vitamin D and SBP (P value for interaction: 0.026).ConclusionOur research showed that magnesium and vitamin D have an interactive effect in reducing SBP, which may have great importance for clinical medication.

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“…All the analyses were performed with the statistical software packages R ( http://www.R-project.org , The R Foundation), Free Statistics software version 1.3 ( 18 ), and EmpowerStats ( http://www.empowerstats.com ). Comparisons of serum vitamin D levels in participants with diabetes and participants without diabetes were performed between low magnesium intake and high magnesium intake.…”

Section: Methodsmentioning

confidence: 99%

Dietary Magnesium Intake Affects the Association Between Serum Vitamin D and Type 2 Diabetes: A Cross-Sectional Study

Huang

Liang

et al. 2021

Front. Nutr.

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Introduction: Circulating vitamin D concentrations have been associated with the risk of type 2 diabetes (T2D). Magnesium has also been reported to be associated with lower T2D risk. Besides, magnesium is an essential cofactor for vitamin D activation. However, the effect of dietary magnesium intake on the association between vitamin D and the risk of T2D has not been studied comprehensively. Therefore, we designed this cross-sectional study to assess the effect modification of magnesium intake on the association between vitamin D and risk of T2D.Research Design and Methods: The present study analyzed data from the National Health and Nutrition Examination Survey (NHANES) continuously from 2007 to 2014, involving 10,249 participants. By having stratified participants based on magnesium intake category (low magnesium intake <267 mg/day; high magnesium intake: ≥267 mg/day), we further evaluated the difference (interaction test) between the relationship of vitamin D with the risk of T2D among low magnesium intake participants and high magnesium intake participants using weighted multivariable logistic regression.Results: In this cross-sectional study, the association of serum vitamin D with the incidence of T2D appeared to differ between the low magnesium intake group and the high magnesium intake group (OR: 0.968, 95%Cl: 0.919–1.02 vs. OR: 0.925, 95%Cl: 0.883–0.97). Furthermore, there was evidence of interaction between vitamin D levels and magnesium intake on decreasing the incidence of T2D (p-value for interaction = 0.001).Conclusions: The results of our study indicated that magnesium intake might affect the association of serum vitamin D with the risk of T2D. Such a finding requires further randomized controlled trials to provide more evidence.

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Association Between Preadmission Metformin Use and Outcomes in Intensive Care Unit Patients With Sepsis and Type 2 Diabetes: A Cohort Study

Cited by 96 publications

References 33 publications

Association of Preadmission Metformin Use and Prognosis in Patients With Sepsis and Diabetes Mellitus: A Systematic Review and Meta-Analysis

Association of Preadmission Metformin Use and Prognosis in Patients With Sepsis and Diabetes Mellitus: A Systematic Review and Meta-Analysis

Dietary Magnesium Intake Modifies the Association Between Vitamin D and Systolic Blood Pressure: Results From NHANES 2007-2014.

Dietary Magnesium Intake Affects the Association Between Serum Vitamin D and Type 2 Diabetes: A Cross-Sectional Study

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