Lancet Healthy Longev:二甲双胍可降低2型糖尿病或肥胖女性COVID-19死亡风险

2021-01-16 MedSci原创 MedSci原创

随着科学家对疫情临床数据的积累,高血压、糖尿病、冠状动脉疾病、吸烟和肥胖已成为感染新冠病毒的重要风险因素。

随着科学家对疫情临床数据的积累,高血压、糖尿病、冠状动脉疾病、吸烟和肥胖已成为感染新冠病毒的重要风险因素。在COVID-19患者肺组织中发现了较高水平的肿瘤坏死因子-α(TNF-α)水平,而TNF-α与胰岛素抵抗有着密切的关系。研究显示,2型糖尿病和肥胖者中普遍存在胰岛素抵抗。然而,二甲双胍是用于2型糖尿病的药物,可降低TNF-α和白介素(IL6,提高抗炎细胞因子白介素(IL10。那么,在2型糖尿病或肥胖人群中,服用二甲双胍是否能降低COVID-19住院患者死亡率。

近日,发表在Lancet Healthy Longev杂志的一项研究显示,双胍可显著降低2型糖尿病或肥胖女性COVID-19死亡率。

在这项回顾性队列分析中,研究人员评估了来自联合健康集团(UHG202011日至67日的6256COVID-19成人患者,且均患有2型糖尿病或肥胖,中位年龄为73岁,其中女性患者有3302名(52·8%)。在所有患者人群中,通过Cox风险分层模型或倾向匹配评分发现,服用二甲双胍与COVID-19的死亡率低均无明显关联。然而,仅在女性中,服用二甲双胍可显著降低COVID-19死亡率。在男性中,服用二甲双胍对COVID-19死亡风险没有显著影响。

研究设计

Kaplan-Meier生存曲线

在不同模型中,女性患者中(绿色柱状)服用二甲双胍的亚组COVID-19死亡风险都更低

研究人员进一步发现,二甲双胍在女性中的TNFα降低幅度大于男性。另外,二甲双胍可以通过血管紧张素转换酶2ACE2)受体调节炎性细胞因子的释放,使得炎症因子降低,嗜中性白细胞与淋巴细胞比例提高,这可能表明减少炎症是二甲双胍降低COVID-19风险的关键机制。

总之,在这项研究中,与男性相比,二甲双胍对患有2型糖尿病或肥胖女性COVID-19患者具有显着的保护作用。但该研究尚存在未得到控制的混杂因素,比如二甲双胍处方记录不等同于实际用药情况等。未来,需要更多研究来证明二甲双胍用于COVID-19治疗和预防的效果。

原始出处

Carolyn T Bramante, et al. Metformin and risk of mortality in patients hospitalised with COVID-19: a retrospective cohort analysiss. The Lancet Healthy Longevity, 2020

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    2021-04-07 howi
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    2021-06-13 shizhenshan
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style='color:#2F92EE;'>#2型糖尿病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=216, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1090, encryptionId=d20f1090c2, topicName=2型糖尿病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=智者为医08, createdTime=Sun Jan 17 11:14:32 CST 2021, time=2021-01-17, status=1, ipAttribution=)]
    2021-03-03 carrotlyl

    神药添新功效

    0

  5. 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style='color:#2F92EE;'>#2型糖尿病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=216, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1090, encryptionId=d20f1090c2, topicName=2型糖尿病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=智者为医08, createdTime=Sun Jan 17 11:14:32 CST 2021, time=2021-01-17, status=1, ipAttribution=)]
  6. 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  7. 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    2021-01-18 1230647

    学习了

    0

  8. 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    2021-01-17 ms3000001340106445

    学习了

    0

  9. 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    2021-01-17 沐子521

    学习了

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