J Gastroenterology:二甲双胍不能降低老年性炎症性肠病的风险

2022-07-26 xuyihan MedSci原创

自身免疫和肠黏膜屏障在其发病机制中起重要作用.研究发现,二甲双胍除了降糖作用外,可通过多种机制调节肠道黏膜的免疫反应而发挥抗炎作用和改善肠黏膜屏障。

近两年越来越多的研究发现,二甲双胍不仅具有降血糖的作用,还有抗衰老抗肿瘤延长寿命等作用。最近有研究发现它居然还能给肠道细菌带来正能量,降低炎症性肠病的发病风险。肠道菌群失调是罪魁祸首;好的肠道菌群就像是肥沃的土壤,通过它的滋养,可以让健康之树长得枝繁叶茂。而坏的肠道菌群就像是布满垃圾和有毒物质的贫瘠河道,会让树变得叶黄枝瘦,在人就表现为罹患很多疾病。二甲双胍具有多效性,包括抗炎特性和对肠道微生物群的影响。它主要用于老年人群。本研究的目的是检查二甲双胍是否可以预防 IBD 的发展。

为此研究人员进行了嵌套病例对照研究。对于每位 IBD 患者,研究人员选择了10名年龄、性别和随访时间相匹配的无IBD个体。条件逻辑回归用于估计 IBD 的优势比 (OR)。调整包括教育水平、其他免疫介导的炎症性疾病以及二肽基肽酶 (DPP)-4 抑制剂和他汀类药物的使用。最后对于二甲双胍对于炎症性肠病的影响进行了分析。

研究结果显示在302863名无IBD的口服降糖药物患者中,总共有1271名发生IBD。IBD 诊断的平均年龄为66岁。研究人员还发现曾经使用二甲双胍与 IBD、克罗恩病或溃疡性结肠炎的风险之间没有关联,调整后的 OR为 0.95 (95% CI 0.78–1.15)、0.87 (95% CI 0.60–1.26) 和 1.04 (95% CI 0.83– 1.31),而且研究人员还发现二甲双胍的累积剂量或二甲双胍的治疗持续时间与 IBD 风险无关。

在这项基于人群的研究中,研究人员证实二甲双胍尽管有抗炎作用和对肠道微生物组的显着影响,但使用二甲双胍与降低老年 IBD 风险无关。

 

原始出处:

Kristine H. Allin. et al. Metformin use is not associated with reduced risk of older onset inflammatory bowel disease: a Danish nationwide population-based study. Journal of Gastroenterology.2022.

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    2022-10-17 许安
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