Abstract：
BACKGROUND: Inhibiting the development and progression of diabetic kidney disease (DKD) is an important issue, but the renoprotective effect of metformin is still controversial.
OBJECTIVE: To assess the renoprotective effect of metformin in patients with type 2 diabetes.
METHODS: This retrospective observational multicenter cohort study included 316,693 patients with type 2 diabetes from seven hospital. After age, gender, medical year, baseline estimated glomerular filtration rate (eGFR), urine protein (dipstick), glycated hemoglobin (HbA1C) and propensity score matching; a total of 13,096 metformin and 13,096 non-metformin patients were included. The main results were doubling of serum creatinine, eGFR ≤ 15 mL/min/1.73 m2 and end stage kidney disease (ESKD).
RESULTS: After conducting a multivariable logistic regression analysis on the variables, the metformin group was revealed to have better renal outcomes than non-metformin group, including a lower incidence of doubling of serum creatinine (hazard ratio [HR], 0.71; 95% CI, 0.65-0.77), eGFR ≤ 15 mL/min/1.73 m2 (HR 0.61; 95% CI 0.53-0.71), and ESKD (HR 0.55; 95% CI 0.47-0.66). The subgroup analyses revealed a consistent renoprotective effect across patients with various renal functions. Furthermore, when considering factors such as age, sex, comorbidities, and medications in subgroup analyses, it consistently showed that the metformin group experienced a slower deterioration in renal function across nearly all patient subgroups.
CONCLUSIONS: Metformin decreased the risk of renal function deterioration.
OBJECTIVE: To assess the renoprotective effect of metformin in patients with type 2 diabetes.
METHODS: This retrospective observational multicenter cohort study included 316,693 patients with type 2 diabetes from seven hospital. After age, gender, medical year, baseline estimated glomerular filtration rate (eGFR), urine protein (dipstick), glycated hemoglobin (HbA1C) and propensity score matching; a total of 13,096 metformin and 13,096 non-metformin patients were included. The main results were doubling of serum creatinine, eGFR ≤ 15 mL/min/1.73 m2 and end stage kidney disease (ESKD).
RESULTS: After conducting a multivariable logistic regression analysis on the variables, the metformin group was revealed to have better renal outcomes than non-metformin group, including a lower incidence of doubling of serum creatinine (hazard ratio [HR], 0.71; 95% CI, 0.65-0.77), eGFR ≤ 15 mL/min/1.73 m2 (HR 0.61; 95% CI 0.53-0.71), and ESKD (HR 0.55; 95% CI 0.47-0.66). The subgroup analyses revealed a consistent renoprotective effect across patients with various renal functions. Furthermore, when considering factors such as age, sex, comorbidities, and medications in subgroup analyses, it consistently showed that the metformin group experienced a slower deterioration in renal function across nearly all patient subgroups.
CONCLUSIONS: Metformin decreased the risk of renal function deterioration.
摘要：
背景：抑制糖尿病肾病（DKD）的发生和发展是一个重要的问题，但二甲双胍的肾脏保护作用仍存在争议。
目的：评估二甲双胍对2型糖尿病患者的肾脏保护作用。
方法：这项回顾性观察多中心队列研究包括来自7家医院的316,693名2型糖尿病患者。年龄之后,性别,医疗年,基线估计肾小球滤过率(eGFR)，尿蛋白（试纸），糖化血红蛋白(HbA1C)和倾向评分匹配;共纳入13,096例二甲双胍和13,096例非二甲双胍患者.主要结果是血清肌酐加倍，eGFR≤15mL/min/1.73m2和终末期肾病（ESKD）。
结果：对变量进行多变量逻辑回归分析后，二甲双胍组的肾脏结局优于非二甲双胍组，包括血清肌酐加倍的发生率较低(危险比[HR]，0.71；95%CI，0.65-0.77），eGFR≤15mL/min/1.73m2（HR0.61；95%CI0.53-0.71），和ESKD（HR0.55；95%CI0.47-0.66）。亚组分析显示，具有各种肾功能的患者具有一致的肾脏保护作用。此外，当考虑到年龄等因素时，性别,合并症,和亚组分析中的药物，结果一致显示,在几乎所有患者亚组中,二甲双胍组的肾功能恶化速度较慢.
结论：二甲双胍可降低肾功能恶化的风险。
目的：评估二甲双胍对2型糖尿病患者的肾脏保护作用。
方法：这项回顾性观察多中心队列研究包括来自7家医院的316,693名2型糖尿病患者。年龄之后,性别,医疗年,基线估计肾小球滤过率(eGFR)，尿蛋白（试纸），糖化血红蛋白(HbA1C)和倾向评分匹配;共纳入13,096例二甲双胍和13,096例非二甲双胍患者.主要结果是血清肌酐加倍，eGFR≤15mL/min/1.73m2和终末期肾病（ESKD）。
结果：对变量进行多变量逻辑回归分析后，二甲双胍组的肾脏结局优于非二甲双胍组，包括血清肌酐加倍的发生率较低(危险比[HR]，0.71；95%CI，0.65-0.77），eGFR≤15mL/min/1.73m2（HR0.61；95%CI0.53-0.71），和ESKD（HR0.55；95%CI0.47-0.66）。亚组分析显示，具有各种肾功能的患者具有一致的肾脏保护作用。此外，当考虑到年龄等因素时，性别,合并症,和亚组分析中的药物，结果一致显示,在几乎所有患者亚组中,二甲双胍组的肾功能恶化速度较慢.
结论：二甲双胍可降低肾功能恶化的风险。
