Recently, according to Bio Valley reports, a study published in Lancet Healthy Longev recently showed that metformin can significantly reduce COVID-19 mortality in type 2 diabetic or obese women.
In this retrospective cohort analysis, the researchers evaluated 6,256 adult patients with COVID-19 from the United Health Group (UHG) from January 1 to June 7, 2020, all with type 2 diabetes or obesity. The median age is 73 years, of which 3302 female patients (52.8%).
In all patient populations, through the Cox risk stratification model or propensity matching score, it was found that there was no significant association between taking metformin and the low mortality rate of COVID-19. However, only in women, taking metformin can significantly reduce COVID-19 mortality. Among men, taking metformin has no significant effect on the risk of death from COVID-19.
The researchers further found that metformin reduced TNFα in women more than men. In addition, metformin can regulate the release of inflammatory cytokines through angiotensin-converting enzyme 2 (ACE2) receptors, which reduces inflammatory factors and increases the ratio of neutrophils to lymphocytes, which may indicate that reducing inflammation is metformin reducing COVID-19 The key mechanism of risk.
In conclusion, in this study, compared with men, metformin has a significant protective effect on COVID-19 patients with type 2 diabetes or obesity. However, there are still uncontrolled confounding factors in the study, such as the fact that the prescription records of metformin are not equivalent to the actual medication. In the future, more studies are needed to prove the effectiveness of metformin in the treatment and prevention of COVID-19.
It is worth noting that this is not the first discussion about the interaction between metformin and the global pandemic of COVID-19. Previous studies have explored the possible positive effects of metformin on patients with COVID-19.
Potential multiple effects
The reason why metformin is called the magic drug is that although it is an old drug with a long history, it has been continuously discovered that it may have other potential multiple effects, including but not limited to, weight loss, More than 20 kinds of anti-cancer and anti-inflammatory.
1. Weight loss
Metformin is a hypoglycemic agent that can lose weight. It can increase insulin sensitivity and reduce fat synthesis. For many type 2 sugar lovers, weight loss itself is a thing that is conducive to stable blood sugar control.
A study by the United States Diabetes Prevention Program (DPP) research team showed that patients who received metformin treatment lost an average of 3.1 kilograms in weight during an unblinded study period of 7-8 years.
2. Anti-aging effect
A few days ago, the US Food and Drug Administration approved a clinical trial of “metformin against aging”. The reason why foreign scientists use metformin as an anti-aging drug candidate may be because metformin can increase the number of oxygen molecules released into cells. Above all, this seems to increase the body's fitness and prolong life.
3. Reverse biological age
The official website of the international science and technology journal "Nature" published a blockbuster news. Reports show that a small clinical study in California showed for the first time that it is possible to reverse the human epigenetic clock. In the past year, nine healthy volunteers took a mixture of growth hormone and two diabetes drugs, including metformin. Measured by analyzing the markers on a person's genome, their biological age has dropped by an average of 2.5 years.
Studies have shown that a team led by Professor Scott Budinger of Northwestern University has confirmed in mice that metformin can prevent inflammation caused by smog, prevent immune cells from releasing a dangerous molecule into the blood, inhibit the formation of arterial thrombosis, and reduce the heart The risk of vascular disease.
5. Assist smoking cessation
Researchers from the University of Pennsylvania have found that long-term nicotine use can lead to the activation of the AMPK signaling pathway, which is inhibited when nicotine withdrawal. Therefore, they inferred that if drugs were used to activate the AMPK signaling pathway, they might alleviate the withdrawal response.
Metformin is an AMPK agonist. When the researchers gave metformin to mice that had nicotine withdrawal, they found that it relieved the mice's withdrawal. Their research shows that metformin can be used to help quit smoking.
Preclinical studies and clinical studies have shown that metformin can not only improve chronic inflammation by improving metabolic parameters such as hyperglycemia, insulin resistance and atherosclerotic dyslipidemia, but also has a direct anti-inflammatory effect.
Studies have pointed out that metformin can inhibit inflammation, mainly through AMP-activated protein kinase (AMPK)-dependent or independent inhibition of nuclear transcription factor B (NFB).
7. It can promote hair growth and treat hair loss
The team of Huang Jing, a Chinese scientist at the University of California, Los Angeles, found that drugs such as metformin and rapamycin can stimulate hair follicles in the resting phase of mice to enter the growth phase and promote hair growth. Related research has been published in the famous academic journal Cell Reports.
Moreover, when scientists used metformin to treat patients with polycystic ovary syndrome in China and India, they have also observed that metformin is associated with reduced hair loss.
In addition, different research results show that there are new discoveries about metformin in some diseases that affect women's health.
8. Reduce the risk of miscarriage and premature delivery for certain pregnant women
A study in The Lancet showed that metformin may reduce the risk of miscarriage and preterm delivery in certain pregnant women.
According to reports, scientists from the Norwegian University of Science and Technology (NTNU) and St. Olavs Hospital conducted a nearly 20-year study and found that patients with polycystic ovary syndrome taking metformin at the end of 3 months of pregnancy may reduce post-term miscarriage and miscarriage. Risk of premature birth.
9. Improve polycystic ovary syndrome
Polycystic ovary syndrome is a heterogeneous disease characterized by hyperandrogenemia, ovarian dysfunction, and polycystic ovary morphology. Its pathogenesis is unclear, and patients often have hyperinsulinemia in varying degrees. Studies have shown that metformin can reduce insulin resistance, restore its ovulation function, and improve hyperandrogenemia.
10. Combination medication may treat triple-negative breast cancer
The team led by Dr. Marsha rich rosner of the University of Chicago found that the combination of metformin and another old drug, heme (panhematin), can target the treatment of triple-negative breast cancer that seriously threatens women’s health.
And there is evidence that this treatment strategy may be effective for a variety of cancers such as lung cancer, kidney cancer, uterine cancer, prostate cancer, and acute myeloid leukemia. Related research has been published in the top journal Nature.
11. Cardiovascular protection
Metformin has cardiovascular protective effects and is currently the only hypoglycemic drug recommended by the diabetes guidelines as having clear evidence of cardiovascular benefit. Studies have shown that long-term treatment of metformin is significantly related to the risk of cardiovascular disease in newly diagnosed type 2 diabetic patients and type 2 diabetic patients who have developed cardiovascular disease.
12. Improve intestinal flora
Studies have shown that metformin can restore the proportion of intestinal flora and make it change in a healthy direction. Provide an advantageous living environment for the beneficial bacteria in the intestines, thereby reducing blood sugar and positively regulating the immune system.
13. It is expected to treat some autism
Recently, researchers at McGill University discovered that metformin can treat certain forms of Fragile X syndrome with autism, and this innovative study was published in the journal NatureMedicine, a subsidiary of Nature. At present, autism is one of many medical conditions that scientists believe can be treated with metformin.
14. Reverse pulmonary fibrosis
Researchers at the University of Alabama at Birmingham found that in human patients with idiopathic pulmonary fibrosis and in mouse models of pulmonary fibrosis induced by bleomycin, the activity of AMPK in fibrotic tissues is reduced, and the tissues resist cells Apoptotic myofibroblasts increased.
Using metformin to activate AMPK in myofibroblasts can re-sensitize these cells to apoptosis. Moreover, in the mouse model, metformin can accelerate the ablation of the already produced fibrotic tissue. This study shows that metformin or other AMPK agonists can be used to reverse fibrosis that has already occurred.
15. Reverse cognitive impairment
Researchers at the University of Texas at Dallas have created a mouse model that mimics pain-related cognitive impairment. They used this model to test the efficacy of multiple drugs.
Experimental results show that treatment of mice with 200 mg/kg body weight of metformin for 7 days can completely reverse the cognitive impairment caused by pain.
Gabapentin, which treats neuralgia and epilepsy, has no such effect. This means that metformin can be used as an old drug to treat cognitive impairment in patients with neuralgia.
16, inhibit tumor growth
A few days ago, according to Singularity.com, scholars from the European Institute of Oncology discovered that metformin and fasting can work synergistically to inhibit the growth of tumors in mice.
Through further research, it was found that metformin and fasting inhibited tumor growth through the PP2A-GSK3β-MCL-1 pathway. The research was published on Cancer Cell.
17, can prevent macular degeneration
Dr. Yu-Yen Chen from Taichung Veterans General Hospital in Taiwan, China recently discovered that the incidence of age-related macular degeneration (AMD) in patients with type 2 diabetes taking metformin is significantly lower. This shows that while controlling diabetes, the anti-inflammatory and antioxidant functions of metformin have a protective effect on AMD.
18. May reduce adverse effects of glucocorticoids
Recently, "The Lancet-Diabetes and Endocrinology" published a study-the results of the study showed that in a phase 2 clinical trial, metformin used in patients with chronic inflammatory diseases can improve metabolic health and reduce glucocorticoid treatment Serious side effects.
Experiments have suggested that metformin may act through the key metabolic protein AMPK, and the mechanism of action is exactly the opposite of glucocorticoids, and has the potential to reverse the side effects of massive use of glucocorticoids.
19. Hope to treat multiple sclerosis
Previously, a research team led by Robin JM Franklin of the University of Cambridge and his disciple Peter van Wijngaarden published an article in the top journal "Cell Stem Cells" that they found a special type of aging neural stem cells that can recover after treatment with metformin In response to differentiation-promoting signals, it reappears youthful vitality and further promotes the regeneration of nerve myelin.
This discovery means that metformin is expected to be used in the treatment of irreversible neurodegeneration-related diseases, such as multiple sclerosis.
20. It is expected to improve the risk of kidney failure and death from kidney disease
WuXi AppTec's Content Team Medical New Vision released news that a study of 10,000 people showed that metformin may improve the risk of kidney failure and death from kidney disease.
A study published in the American Diabetes Association (ADA) journal "Diabetes Care" (Diabetes Care) showed that the medication and survival analysis of more than 10,000 people showed that type 2 diabetes patients with chronic kidney disease (CKD) take Metformin is associated with a reduced risk of death and end-stage renal disease (ESRD) without increasing the risk of lactic acidosis.
Although there are so many exciting discoveries about metformin, the drug is three points poisonous. You should not buy the drug yourself and use it under the guidance of a physician.
21. It can protect the stomach and reduce the risk of stomach cancer
Recently, the official website of "Cell Stem Cell", a subsidiary of the world's top scientific journal "CELL", has updated the latest research on metformin: Metformin can regulate the metabolism of stem cells in the stomach and promote their differentiation into gastric parietal cells that produce gastric acid.
Studies have shown that the AMPK metabolic pathway promotes the generation of acid-secreting parietal cells by stem cells. Metformin slows down the proliferation of progenitor cells by activating AMPK and KLF4, and can also induce parietal cell maturation by activating AMPK and PGC1a. This is why metformin increases acid secretion and Lowering people's risk of stomach cancer provides potential hints.
In addition, a 2018 study showed that the use of metformin reduced the risk of gastric cancer by 51% in diabetic patients with Helicobacter pylori eradicated in a sustained and dose-responsive manner.
22. Take preoperatively to reduce patient mortality
According to WuXi AppTec's account medicine new perspective news, a recent study published in the Journal of the American Medical Association-Surgery found that the classic hypoglycemic drug metformin has another benefit in addition to blood sugar control: taking metformin before surgery may It is related to the postoperative mortality of diabetic patients and the reduced risk of readmission.
23. Extend the survival time of patients with advanced bowel cancer with KRAS mutations
According to Singularity.com, recently, a team of Chinese scientists, Gao Guoquan, Sun Yat-sen University and Zhongshan School of Medicine, published important research results in the famous journal PNAS.
They analyzed the treatment data of thousands of patients with advanced bowel cancer and found that among patients with advanced bowel cancer with KRAS mutations, compared with other types of hypoglycemic drugs, the overall survival time of intestinal cancer patients taking metformin was 37.8 times longer. Months, the median progression-free survival time (mPFS) was extended by 8.1 months.
24. Preventing cancer and stroke trends
According to news from the new medical perspective, the 80th Scientific Meeting of the American Diabetes Association (2020 ADA Annual Meeting) announced the latest data from the Diabetes Prevention Program Outcome Study (DPPOS)-Metformin has continued to reduce the risk of diabetes for 22 years, showing the trend of preventing cancer and stroke.
25, repair brain damage
In the journal Nature Medicine, researchers from the Institute of Medical Sciences of the University of Toronto in Canada and Toronto Children’s Hospital published the results of the test: For children with brain tumor patients who have received craniocerebral radiotherapy, metformin is more pronounced than placebo Improved their working memory and statement memory function, repaired white matter damage.
26. Benefit patients with esophageal squamous cell carcinoma
Recently, the oncology journal Clinical Cancer Research published the results of a Phase II clinical study completed by researchers from Shantou University and other institutions.
The paper showed that the hypoglycemic drug metformin may benefit patients with esophageal squamous cell carcinoma by improving the immune microenvironment (TIME) in tumor lesions.
27, or reduce the risk of dementia
Recently, the journal Diabetes Diagnosis and Treatment, a journal of the American Diabetes Association, published a study from Australia-the above study found that the cognitive function of patients with type 2 diabetes taking metformin declined
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