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논문분류	춘계학술대회 초록집
제목	Effect of long-term use of metformin on patients with type 2 diabetes: a multicentric, comparative cohort study using common data model
저자	YongJin Yi
출판정보	2023; 2023(1):
키워드
초록	Objectives: Metformin is a first-line oral hypoglycemic agent (OHA) in patients with type 2 diabetes (T2DM).Although metformin is widely used in patients with T2DM, there are merely no recent trials that targeting to compare the effects of metformin with newer OHAs. This study aim to investigatethe effect of metformin on diabetic nephropathy in patients with T2DM. Methods: We conducted a multicenter observational study among heterogeneous tertiary hospitals in South Korea to evaluate the effect of metformin on DN using the common data model provided by the OHDSI collaborative.We used data from three different referral hospitals’ electronic medical records (EMR) databases: Seoul National University Bundang Hospital (SNUBH), Asan Medical center (AMC), and Seoul National University Hospital (SNUH).Study participants were identified by drugs, diagnosis codes and laboratory test values in combination with event time. Among diagnosed T2DM patients with or without CKD, long term use of metformin treatment wasconsidered as treatment group. Never use of metformin after four months since time of T2DM diagnosis were considered as comparative group (Fig 1). After 1:1 propensity score-based matching (PSM), meta-analysis with fixed and random effect model was used to analyze hazard ratio (HR) for DN, major cardiovascular and renal events. Results: After PSM, a total of 1,721 of T2DM patients without CKD and total of 4,999, 3,287, and 1,395 patients with CKD stage 3A, 3B, 4 were analyzed. Meta-analyzed incidence rate ratios of MACE in long-term metformin user group were 0.78 (0.64-0.92), 0.71 (0.55-0.91), 0.83 (0.74-0.92), and 0.71 (0.60-0.85)in cohorts without CKD and with CKD stage 3A, 3B, 4, respectively. Conclusions: A multicenter meta-analysis of T2DM patients was performed using CDM.Long-term use of meformin reduced the incidence of MACE at all stages of renal function.
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