Effects of metformin exposure on neurodegenerative diseases in elderly patients with type 2 diabetes mellitus

Yi Chun Kuan, Kuang Wei Huang, Cheng Li Lin, Chaur Jong Hu, Chia Hung Kao

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Epidemiological evidence reveals that patients with type 2 diabetes mellitus (T2DM) have an increased risk of neurodegenerative diseases (NDs), including dementia and Parkinson's disease (PD). The effects of metformin exposure on dementia and PD risk in patients with T2DM are unknown. We evaluated the effects of metformin exposure on the risk of dementia and PD in patients with T2DM. We performed a cohort study by using Taiwan's National Health Insurance Research Database. We recruited 4651 patients in the metformin cohort and a comparable number of nonmetformin controls by using propensity score matching. Multivariate Cox proportional hazards regression was used to estimate the effects of metformin on the risk of dementia and PD after adjustment for several confounding factors. During the 12-year follow-up, the metformin cohort exhibited a higher risk of PD than the nonmetformin cohort (hazard ratio [HR]: 2.27, 95% confidence interval [CI] = 1.68–3.07). The metformin cohort had an increased risk of all-cause dementia (HR: 1.66, 95% CI = 1.35–2.04). Moreover, metformin exposure increased the risk of Alzheimer's disease (HR: 2.13, 95% CI = 1.20–3.79) and vascular dementia (HR: 2.30, 95% CI = 1.25–4.22). The effects of exposure duration and dosage on dementia and PD occurrence were also observed. Long-term metformin exposure in patients with T2DM may lead to the development of NDs, including dementia and PD. Additional large-scale, prospective controlled trials are required to confirm the observed association in patients with T2DM.

Original languageEnglish
Pages (from-to)77-83
Number of pages7
JournalProgress in Neuro-Psychopharmacology and Biological Psychiatry
Volume79
DOIs
Publication statusPublished - Oct 3 2017

Fingerprint

Metformin
Neurodegenerative Diseases
Type 2 Diabetes Mellitus
Parkinson Disease
Dementia
Confidence Intervals
Propensity Score
Vascular Dementia
National Health Programs
Taiwan
Alzheimer Disease
Cohort Studies
Databases
Research

Keywords

  • Alzheimer's disease
  • Dementia
  • Diabetes mellitus
  • Metformin
  • Parkinson's disease

ASJC Scopus subject areas

  • Pharmacology
  • Biological Psychiatry

Cite this

Effects of metformin exposure on neurodegenerative diseases in elderly patients with type 2 diabetes mellitus. / Kuan, Yi Chun; Huang, Kuang Wei; Lin, Cheng Li; Hu, Chaur Jong; Kao, Chia Hung.

In: Progress in Neuro-Psychopharmacology and Biological Psychiatry, Vol. 79, 03.10.2017, p. 77-83.

Research output: Contribution to journalArticle

@article{df72527116dd4b3780dee1b69f5ed3cf,
title = "Effects of metformin exposure on neurodegenerative diseases in elderly patients with type 2 diabetes mellitus",
abstract = "Epidemiological evidence reveals that patients with type 2 diabetes mellitus (T2DM) have an increased risk of neurodegenerative diseases (NDs), including dementia and Parkinson's disease (PD). The effects of metformin exposure on dementia and PD risk in patients with T2DM are unknown. We evaluated the effects of metformin exposure on the risk of dementia and PD in patients with T2DM. We performed a cohort study by using Taiwan's National Health Insurance Research Database. We recruited 4651 patients in the metformin cohort and a comparable number of nonmetformin controls by using propensity score matching. Multivariate Cox proportional hazards regression was used to estimate the effects of metformin on the risk of dementia and PD after adjustment for several confounding factors. During the 12-year follow-up, the metformin cohort exhibited a higher risk of PD than the nonmetformin cohort (hazard ratio [HR]: 2.27, 95{\%} confidence interval [CI] = 1.68–3.07). The metformin cohort had an increased risk of all-cause dementia (HR: 1.66, 95{\%} CI = 1.35–2.04). Moreover, metformin exposure increased the risk of Alzheimer's disease (HR: 2.13, 95{\%} CI = 1.20–3.79) and vascular dementia (HR: 2.30, 95{\%} CI = 1.25–4.22). The effects of exposure duration and dosage on dementia and PD occurrence were also observed. Long-term metformin exposure in patients with T2DM may lead to the development of NDs, including dementia and PD. Additional large-scale, prospective controlled trials are required to confirm the observed association in patients with T2DM.",
keywords = "Alzheimer's disease, Dementia, Diabetes mellitus, Metformin, Parkinson's disease",
author = "Kuan, {Yi Chun} and Huang, {Kuang Wei} and Lin, {Cheng Li} and Hu, {Chaur Jong} and Kao, {Chia Hung}",
year = "2017",
month = "10",
day = "3",
doi = "10.1016/j.pnpbp.2017.06.002",
language = "English",
volume = "79",
pages = "77--83",
journal = "Progress in Neuro-Psychopharmacology and Biological Psychiatry",
issn = "0278-5846",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Effects of metformin exposure on neurodegenerative diseases in elderly patients with type 2 diabetes mellitus

AU - Kuan, Yi Chun

AU - Huang, Kuang Wei

AU - Lin, Cheng Li

AU - Hu, Chaur Jong

AU - Kao, Chia Hung

PY - 2017/10/3

Y1 - 2017/10/3

N2 - Epidemiological evidence reveals that patients with type 2 diabetes mellitus (T2DM) have an increased risk of neurodegenerative diseases (NDs), including dementia and Parkinson's disease (PD). The effects of metformin exposure on dementia and PD risk in patients with T2DM are unknown. We evaluated the effects of metformin exposure on the risk of dementia and PD in patients with T2DM. We performed a cohort study by using Taiwan's National Health Insurance Research Database. We recruited 4651 patients in the metformin cohort and a comparable number of nonmetformin controls by using propensity score matching. Multivariate Cox proportional hazards regression was used to estimate the effects of metformin on the risk of dementia and PD after adjustment for several confounding factors. During the 12-year follow-up, the metformin cohort exhibited a higher risk of PD than the nonmetformin cohort (hazard ratio [HR]: 2.27, 95% confidence interval [CI] = 1.68–3.07). The metformin cohort had an increased risk of all-cause dementia (HR: 1.66, 95% CI = 1.35–2.04). Moreover, metformin exposure increased the risk of Alzheimer's disease (HR: 2.13, 95% CI = 1.20–3.79) and vascular dementia (HR: 2.30, 95% CI = 1.25–4.22). The effects of exposure duration and dosage on dementia and PD occurrence were also observed. Long-term metformin exposure in patients with T2DM may lead to the development of NDs, including dementia and PD. Additional large-scale, prospective controlled trials are required to confirm the observed association in patients with T2DM.

AB - Epidemiological evidence reveals that patients with type 2 diabetes mellitus (T2DM) have an increased risk of neurodegenerative diseases (NDs), including dementia and Parkinson's disease (PD). The effects of metformin exposure on dementia and PD risk in patients with T2DM are unknown. We evaluated the effects of metformin exposure on the risk of dementia and PD in patients with T2DM. We performed a cohort study by using Taiwan's National Health Insurance Research Database. We recruited 4651 patients in the metformin cohort and a comparable number of nonmetformin controls by using propensity score matching. Multivariate Cox proportional hazards regression was used to estimate the effects of metformin on the risk of dementia and PD after adjustment for several confounding factors. During the 12-year follow-up, the metformin cohort exhibited a higher risk of PD than the nonmetformin cohort (hazard ratio [HR]: 2.27, 95% confidence interval [CI] = 1.68–3.07). The metformin cohort had an increased risk of all-cause dementia (HR: 1.66, 95% CI = 1.35–2.04). Moreover, metformin exposure increased the risk of Alzheimer's disease (HR: 2.13, 95% CI = 1.20–3.79) and vascular dementia (HR: 2.30, 95% CI = 1.25–4.22). The effects of exposure duration and dosage on dementia and PD occurrence were also observed. Long-term metformin exposure in patients with T2DM may lead to the development of NDs, including dementia and PD. Additional large-scale, prospective controlled trials are required to confirm the observed association in patients with T2DM.

KW - Alzheimer's disease

KW - Dementia

KW - Diabetes mellitus

KW - Metformin

KW - Parkinson's disease

UR - http://www.scopus.com/inward/record.url?scp=85021071042&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85021071042&partnerID=8YFLogxK

U2 - 10.1016/j.pnpbp.2017.06.002

DO - 10.1016/j.pnpbp.2017.06.002

M3 - Article

C2 - 28583443

AN - SCOPUS:85021071042

VL - 79

SP - 77

EP - 83

JO - Progress in Neuro-Psychopharmacology and Biological Psychiatry

JF - Progress in Neuro-Psychopharmacology and Biological Psychiatry

SN - 0278-5846

ER -