Metformin use and the risk of anal intraepithelial neoplasia in type II diabetic patients

Hsu, An; Hung, Ya‐Ching; Fang, Sandy H.; D’Adamo, Christopher R.; Mavanur, Arun; Svoboda, Shane; Wolf, Joshua H.

doi:10.1111/codi.15860

Cited by 2 publications

(1 citation statement)

References 32 publications

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“…Metformin, an insulin sensitizer that reduces hyperinsulinemia, is one of the oldest type 2 DM medications and currently the first-line medication for type 2 DM; it was used by over 76% of patients in our study and may be a possible reason for the low prevalence of cervical lesions seen in this study. Studies have shown that patients on metformin have a lower incidence of particular HPV-associated malignancies, including cervical cancer [ 16 , 35 , 36 ]. This is believed to be attributable to decreased cell proliferation, increased apoptosis, decreased cell invasion and migration, and arrest of the G2/M phases of the cell cycle [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of high-risk human papillomavirus infection among women with diabetes mellitus in Accra, Ghana

Atiase,

Effah,

Mawusi Wormenor

et al. 2024

BMC Women's Health

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Background There is increasing evidence of a higher risk and poorer prognosis of cervical cancer among women with diabetes mellitus (DM) compared to the general population. These are mediated by higher susceptibility to persistent high-risk human papillomavirus (hr-HPV) infection due to dysfunctional clearance in an immunocompromised state. We aimed to determine the prevalence of hr-HPV infection and cervical lesions in a cohort of women with DM in Ghana. We further disaggregated the prevalence according to DM type and explored factors associated with hr-HPV infection. Methods This retrospective descriptive cross-sectional study assessed 198 women with DM who underwent cervical screening via concurrent hr-HPV DNA testing and visual inspection with acetic acid in an outpatient department of the National Diabetes Management and Research Centre in Korle-Bu Teaching Hospital, Accra from March to May 2022. Univariate and multivariable binary logistic regression were used to explore factors associated with hr-HPV positivity. Results Among 198 women with DM (mean age, 60.2 ± 12.1 years), the overall hr-HPV prevalence rate was 21.7% (95% CI, 16.1–28.1), disaggregated as 1.5% (95% CI, 0.3–4.4) each for HPV16 and HPV18 and 20.7% (95% CI, 15.3–27.0) for other HPV genotype(s). Respective hr-HPV prevalence rates were 37.5% (95% CI, 15.2–64.6) for type 1 DM, 19.8% (95% CI, 13.9–26.7) for type 2 DM, and 25.0% (95% CI, 8.7–49.1) for unspecified/other DM types. Past use of the combined contraceptive pill independently increased the risk of hr-HPV infection by approximately three times (adjusted odds ratio [aOR] = 2.98; 95% CI, 1.03 − 8.64; p-value = 0.045), whereas each unit increase in FBG level increased the odds of hr-HPV infection by about 15% (aOR = 1.15; 95% CI, 1.02 − 1.30; p-value = 0.021). Conclusion Our study points to a high prevalence of hr-HPV among women with DM and highlights a need for glycemic control among them as this could contribute to lowering their odds of hr-HPV infection. The low overall rates of HPV vaccination and prior screening also indicate a need to build capacity and expand the scope of education and services offered to women with DM as regards cervical precancer screening.

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Section: Discussionmentioning

confidence: 99%

Prevalence of high-risk human papillomavirus infection among women with diabetes mellitus in Accra, Ghana

Atiase,

Effah,

Mawusi Wormenor

et al. 2024

BMC Women's Health

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Metformin in Antiviral Therapy: Evidence and Perspectives

Halabitska,

Petakh,

Lushchak

et al. 2024

Viruses

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Metformin, a widely used antidiabetic medication, has emerged as a promising broad-spectrum antiviral agent due to its ability to modulate cellular pathways essential for viral replication. By activating AMPK, metformin depletes cellular energy reserves that viruses rely on, effectively limiting the replication of pathogens such as influenza, HIV, SARS-CoV-2, HBV, and HCV. Its role in inhibiting the mTOR pathway, crucial for viral protein synthesis and reactivation, is particularly significant in managing infections caused by HIV, CMV, and EBV. Furthermore, metformin reduces oxidative stress and reactive oxygen species (ROS), which are critical for replicating arboviruses such as Zika and dengue. The drug also regulates immune responses, cellular differentiation, and inflammation, disrupting the life cycle of HPV and potentially other viruses. These diverse mechanisms suppress viral replication, enhance immune system functionality, and contribute to better clinical outcomes. This multifaceted approach highlights metformin’s potential as an adjunctive therapy in treating a wide range of viral infections.

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Metformin use and the risk of anal intraepithelial neoplasia in type II diabetic patients

Cited by 2 publications

References 32 publications

Prevalence of high-risk human papillomavirus infection among women with diabetes mellitus in Accra, Ghana

Prevalence of high-risk human papillomavirus infection among women with diabetes mellitus in Accra, Ghana

Metformin in Antiviral Therapy: Evidence and Perspectives

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