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Metformin Decreases Risk of Tuberculosis Infection in Type 2 Diabetes Patients

Background: Metformin may show an antibiotic effect, but whether its use can reduce the risk of tuberculosis infection has rarely been investigated in population-based studies. Methods: This is a retrospective cohort analysis of the Taiwan’s National Health Insurance database. New-onset type 2 diabe...

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Autor principal: Tseng, Chin-Hsiao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6162822/
https://www.ncbi.nlm.nih.gov/pubmed/30205606
http://dx.doi.org/10.3390/jcm7090264
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author Tseng, Chin-Hsiao
author_facet Tseng, Chin-Hsiao
author_sort Tseng, Chin-Hsiao
collection PubMed
description Background: Metformin may show an antibiotic effect, but whether its use can reduce the risk of tuberculosis infection has rarely been investigated in population-based studies. Methods: This is a retrospective cohort analysis of the Taiwan’s National Health Insurance database. New-onset type 2 diabetes patients, 148,468 ever users and 15,799 never users of metformin, identified during 1999–2005 were followed up until 31 December 2011 for the incidence of tuberculosis infection. Hazard ratios were estimated by Cox regression incorporated with the inverse probability of treatment weighting using propensity score. Results: A total of 360 never users and 1976 ever users developed a tuberculosis infection with respective incidence of 510.91 and 282.94 per 100,000 person–years. The overall hazard ratio of presenting a tuberculosis infection among metformin ever users in respect to never users was 0.552 (95% confidence interval: 0.493–0.617). The hazard ratios for the first (<27.10 months), second (27.10–58.27 months), and third (>58.27 months) tertile of cumulative duration of metformin therapy were 1.116 (0.989–1.261), 0.543 (0.478–0.618), and 0.200 (0.171–0.233), respectively; and were 1.037 (0.918–1.173), 0.533 (0.469–0.606), and 0.249 (0.215–0.288), respectively, for the first (<817,000 mg), second (817,000–2,047,180 mg), and third (>2,047,180 mg) tertile of cumulative doses of metformin. The findings were consistent when analyses were restricted to pulmonary tuberculosis. Additionally, regular users of metformin tended to have greater benefit than irregular users. Conclusions: Metformin use is associated with a reduced risk of tuberculosis infection in a dose–response pattern in type 2 diabetes patients.
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spelling pubmed-61628222018-10-02 Metformin Decreases Risk of Tuberculosis Infection in Type 2 Diabetes Patients Tseng, Chin-Hsiao J Clin Med Article Background: Metformin may show an antibiotic effect, but whether its use can reduce the risk of tuberculosis infection has rarely been investigated in population-based studies. Methods: This is a retrospective cohort analysis of the Taiwan’s National Health Insurance database. New-onset type 2 diabetes patients, 148,468 ever users and 15,799 never users of metformin, identified during 1999–2005 were followed up until 31 December 2011 for the incidence of tuberculosis infection. Hazard ratios were estimated by Cox regression incorporated with the inverse probability of treatment weighting using propensity score. Results: A total of 360 never users and 1976 ever users developed a tuberculosis infection with respective incidence of 510.91 and 282.94 per 100,000 person–years. The overall hazard ratio of presenting a tuberculosis infection among metformin ever users in respect to never users was 0.552 (95% confidence interval: 0.493–0.617). The hazard ratios for the first (<27.10 months), second (27.10–58.27 months), and third (>58.27 months) tertile of cumulative duration of metformin therapy were 1.116 (0.989–1.261), 0.543 (0.478–0.618), and 0.200 (0.171–0.233), respectively; and were 1.037 (0.918–1.173), 0.533 (0.469–0.606), and 0.249 (0.215–0.288), respectively, for the first (<817,000 mg), second (817,000–2,047,180 mg), and third (>2,047,180 mg) tertile of cumulative doses of metformin. The findings were consistent when analyses were restricted to pulmonary tuberculosis. Additionally, regular users of metformin tended to have greater benefit than irregular users. Conclusions: Metformin use is associated with a reduced risk of tuberculosis infection in a dose–response pattern in type 2 diabetes patients. MDPI 2018-09-09 /pmc/articles/PMC6162822/ /pubmed/30205606 http://dx.doi.org/10.3390/jcm7090264 Text en © 2018 by the author. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Tseng, Chin-Hsiao
Metformin Decreases Risk of Tuberculosis Infection in Type 2 Diabetes Patients
title Metformin Decreases Risk of Tuberculosis Infection in Type 2 Diabetes Patients
title_full Metformin Decreases Risk of Tuberculosis Infection in Type 2 Diabetes Patients
title_fullStr Metformin Decreases Risk of Tuberculosis Infection in Type 2 Diabetes Patients
title_full_unstemmed Metformin Decreases Risk of Tuberculosis Infection in Type 2 Diabetes Patients
title_short Metformin Decreases Risk of Tuberculosis Infection in Type 2 Diabetes Patients
title_sort metformin decreases risk of tuberculosis infection in type 2 diabetes patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6162822/
https://www.ncbi.nlm.nih.gov/pubmed/30205606
http://dx.doi.org/10.3390/jcm7090264
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