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Association between Metformin Use and Risk of Lactic Acidosis or Elevated Lactate Concentration in Type 2 Diabetes
PURPOSE: Metformin can reduce diabetes-related complications and mortality. However, its use is limited because of potential lactic acidosis-associated adverse effects, particularly in renal impairment patients. We aimed to investigate the association of metformin use with lactic acidosis and hyperl...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Yonsei University College of Medicine
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5290010/ https://www.ncbi.nlm.nih.gov/pubmed/28120561 http://dx.doi.org/10.3349/ymj.2017.58.2.312 |
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author | Lee, Eun Young Hwang, Sena Lee, Yong-ho Lee, Seo Hee Lee, Young Mi Kang, Hua Pyong Han, Eugene Lee, Woonhyoung Lee, Byung-Wan Kang, Eun Seok Cha, Bong Soo Lee, Hyun Chul |
author_facet | Lee, Eun Young Hwang, Sena Lee, Yong-ho Lee, Seo Hee Lee, Young Mi Kang, Hua Pyong Han, Eugene Lee, Woonhyoung Lee, Byung-Wan Kang, Eun Seok Cha, Bong Soo Lee, Hyun Chul |
author_sort | Lee, Eun Young |
collection | PubMed |
description | PURPOSE: Metformin can reduce diabetes-related complications and mortality. However, its use is limited because of potential lactic acidosis-associated adverse effects, particularly in renal impairment patients. We aimed to investigate the association of metformin use with lactic acidosis and hyperlactatemia in patients with type 2 diabetes. MATERIALS AND METHODS: This was a cross-sectional study from a tertiary university-affiliated medical center. A total of 1954 type 2 diabetes patients were recruited in 2007–2011, and stratified according to the estimated glomerular filtration rate of 60 mL/min/1.73 m(2). Lactic acidosis was defined as plasma lactate levels >5 mmol/L and arterial pH <7.35. RESULTS: Metformin was used in 61.4% of the patients with type 2 diabetes mellitus. Plasma lactate levels were not different in the patients with and without metformin use. There was no difference in prevalence of hyperlactatemia and lactic acidosis between the patients with and without metformin use (18.9% vs. 18.7%, p=0.905 for hyperlactatemia and 2.8% vs. 3.3%, p=0.544 for lactic acidosis). Similar results were observed in the patients with estimated glomerular filtration rate <60 mL/min/1.73 m(2). Most patients with lactic acidosis had at least one condition related to hypoxia or poor tissue perfusion. Multiple regression analysis indicated no association between metformin use and lactic acidosis, whereas tissue hypoxia was an independent risk factor for lactic acidosis [odds ratio 4.603 (95% confidence interval, 1.327–15.965)]. CONCLUSION: Metformin use was not associated with hyperlactatemia or lactic acidosis in patients with type 2 diabetes. |
format | Online Article Text |
id | pubmed-5290010 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Yonsei University College of Medicine |
record_format | MEDLINE/PubMed |
spelling | pubmed-52900102017-03-01 Association between Metformin Use and Risk of Lactic Acidosis or Elevated Lactate Concentration in Type 2 Diabetes Lee, Eun Young Hwang, Sena Lee, Yong-ho Lee, Seo Hee Lee, Young Mi Kang, Hua Pyong Han, Eugene Lee, Woonhyoung Lee, Byung-Wan Kang, Eun Seok Cha, Bong Soo Lee, Hyun Chul Yonsei Med J Original Article PURPOSE: Metformin can reduce diabetes-related complications and mortality. However, its use is limited because of potential lactic acidosis-associated adverse effects, particularly in renal impairment patients. We aimed to investigate the association of metformin use with lactic acidosis and hyperlactatemia in patients with type 2 diabetes. MATERIALS AND METHODS: This was a cross-sectional study from a tertiary university-affiliated medical center. A total of 1954 type 2 diabetes patients were recruited in 2007–2011, and stratified according to the estimated glomerular filtration rate of 60 mL/min/1.73 m(2). Lactic acidosis was defined as plasma lactate levels >5 mmol/L and arterial pH <7.35. RESULTS: Metformin was used in 61.4% of the patients with type 2 diabetes mellitus. Plasma lactate levels were not different in the patients with and without metformin use. There was no difference in prevalence of hyperlactatemia and lactic acidosis between the patients with and without metformin use (18.9% vs. 18.7%, p=0.905 for hyperlactatemia and 2.8% vs. 3.3%, p=0.544 for lactic acidosis). Similar results were observed in the patients with estimated glomerular filtration rate <60 mL/min/1.73 m(2). Most patients with lactic acidosis had at least one condition related to hypoxia or poor tissue perfusion. Multiple regression analysis indicated no association between metformin use and lactic acidosis, whereas tissue hypoxia was an independent risk factor for lactic acidosis [odds ratio 4.603 (95% confidence interval, 1.327–15.965)]. CONCLUSION: Metformin use was not associated with hyperlactatemia or lactic acidosis in patients with type 2 diabetes. Yonsei University College of Medicine 2017-03-01 2017-01-16 /pmc/articles/PMC5290010/ /pubmed/28120561 http://dx.doi.org/10.3349/ymj.2017.58.2.312 Text en © Copyright: Yonsei University College of Medicine 2017 http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Lee, Eun Young Hwang, Sena Lee, Yong-ho Lee, Seo Hee Lee, Young Mi Kang, Hua Pyong Han, Eugene Lee, Woonhyoung Lee, Byung-Wan Kang, Eun Seok Cha, Bong Soo Lee, Hyun Chul Association between Metformin Use and Risk of Lactic Acidosis or Elevated Lactate Concentration in Type 2 Diabetes |
title | Association between Metformin Use and Risk of Lactic Acidosis or Elevated Lactate Concentration in Type 2 Diabetes |
title_full | Association between Metformin Use and Risk of Lactic Acidosis or Elevated Lactate Concentration in Type 2 Diabetes |
title_fullStr | Association between Metformin Use and Risk of Lactic Acidosis or Elevated Lactate Concentration in Type 2 Diabetes |
title_full_unstemmed | Association between Metformin Use and Risk of Lactic Acidosis or Elevated Lactate Concentration in Type 2 Diabetes |
title_short | Association between Metformin Use and Risk of Lactic Acidosis or Elevated Lactate Concentration in Type 2 Diabetes |
title_sort | association between metformin use and risk of lactic acidosis or elevated lactate concentration in type 2 diabetes |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5290010/ https://www.ncbi.nlm.nih.gov/pubmed/28120561 http://dx.doi.org/10.3349/ymj.2017.58.2.312 |
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