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Abstract
Persons with type 2 diabetes (T2D) have neutrophil dysfunction with a higher risk of infection than those without diabetes. We conducted this study aiming to compare the risk of pneumonia between metformin use and nonuse in persons with T2D. We identified 49,012 propensity score-matched metformin users and nonusers from Taiwan’s National Health Insurance Research Database between January 1, 2000, and December 31, 2017. We used the Cox proportional hazards model to compare the risks of pneumonia and respiratory death. The mean (SD) age of the participants was 57.46 (12.88) years, and the mean follow-up time for metformin users and nonusers was 5.47 (3.71) years and 5.15 (3.87) years, respectively. Compared with the nonuse of metformin, the adjusted hazard ratios (95% CI) for metformin use in bacterial pneumonia, invasive mechanical ventilation, and respiratory cause of death were 0.89 (0.84–0.94), 0.77 (0.73–0.82), and 0.64 (0.56–0.74), respectively. A longer cumulative duration of metformin use had further lower adjusted hazard ratios in these risks compared with nonuse. In patients with T2D, metformin use was associated with significantly lower risks of bacterial pneumonia, invasive mechanical ventilation, and respiratory cause of death; moreover, longer metformin use duration was associated with lower hazard ratios of these risks.
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1 Dr. Yen’s Clinic, Taoyüan, Taiwan
2 Chung Shan Medical University Hospital, Division of Allergy, Immunology and Rheumatology, Taichung City, Taiwan (GRID:grid.411645.3) (ISNI:0000 0004 0638 9256)
3 China Medical University Hospital, Management Office for Health Data, Taichung, Taiwan (GRID:grid.411508.9) (ISNI:0000 0004 0572 9415); China Medical University, College of Medicine, Taichung City, Taiwan (GRID:grid.254145.3) (ISNI:0000 0001 0083 6092)
4 National Health Research Institutes, Institute of Population Health Sciences, Zhunan, Miaoli County, Taiwan (GRID:grid.59784.37) (ISNI:0000000406229172); National Health Research Institutes, Ceneter for Geriatrics and Welfare Research, Zhunan, Miaoli County, Taiwan (GRID:grid.59784.37) (ISNI:0000000406229172); China Medical University, Department of Health Services Administration, Taichung, Taiwan (GRID:grid.254145.3) (ISNI:0000 0001 0083 6092); Min-Sheng General Hospital, Department of Family Medicine, Taoyüan, Taiwan (GRID:grid.415675.4) (ISNI:0000 0004 0572 8359)
5 National Yang-Ming Chiao Tung University School of Medicine, Faculty of Medicine, Taipei, Taiwan (GRID:grid.260539.b) (ISNI:0000 0001 2059 7017); Taipei Veterans General Hospital, Section of Endocrinology and Metabolism, Department of Medicine, Taipei, Taiwan (GRID:grid.278247.c) (ISNI:0000 0004 0604 5314)