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 reduction in the risk of death and end-stage renal disease (ESRD), and does not increase the risk of lactic acidosis.
Chronic kidney disease is a common complication of diabetes. Considering that patients with mild kidney disease may be prescribed metformin, the research team investigated 2704 patients in each of the two groups taking metformin and not taking metformin.
The results showed that compared with those who did not take metformin, patients who took metformin had a 35% reduction in the risk of all-cause death and a 33% reduction in the risk of progression to end-stage renal disease. These benefits gradually appeared after about 2.5 years of taking metformin.
According to the report, in recent years, the US FDA's guidelines recommend relaxing the use of metformin in patients with type 2 diabetes with chronic kidney disease, but only in patients with mild kidney disease. For patients with moderate (stage 3B) and severe chronic kidney disease, the use of metformin is still controversial.
Dr. Katherine R. Tuttle, a professor at the University of Washington in the United States, commented: “The results of the study are reassuring. Even in patients with severe kidney disease, the risk of lactic acidosis is very low. For patients with type 2 diabetes and chronic kidney disease, metformin may be a preventive measure of death and An important drug for kidney failure, but since this is a retrospective and observational study, the results must be interpreted carefully."
2. Diverse therapeutic potentials of the magic drug metformin
Metformin can be said to be a classic old medicine that has lasted for a long time. In the upsurge of hypoglycemic drug research, in 1957, French scientist Stern published his research results and added the lilac extract that has hypoglycemic activity in goat beans. Alkali, named metformin, Glucophage, which means sugar eater.
In 1994, metformin was officially approved by the US FDA for use in type 2 diabetes. Metformin, as the authoritative drug for the treatment of type 2 diabetes, is listed as a first-line hypoglycemic drug in a variety of treatment guidelines at home and abroad. It has the advantages of accurate hypoglycemic effect, low risk of hypoglycemia, and low price. It is currently the most widely used drug One of the class of hypoglycemic drugs.
As a time-tested drug, it is estimated that there are more than 120 million users of metformin worldwide.
With the deepening of research, the therapeutic potential of metformin has been continuously expanded. In addition to the latest discoveries, metformin has also been found to have nearly 20 effects.
1. Anti-aging effect
At present, the U.S. Food and Drug Administration has approved the clinical trial of "using metformin to fight 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.
2. 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 control of blood sugar.
A study by the United States Diabetes Prevention Program (DPP) research team showed that in an unblinded study period of 7-8 years, patients who received metformin treatment lost an average of 3.1 kg in weight.
3. Reduce the risk of miscarriage and premature delivery for certain pregnant women
The latest research published in The Lancet shows 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.
4. Prevent inflammation caused by smog
The results of the study showed that the team led by Professor Scott Budinger of Northwestern University 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 thereby reduce the cardiovascular system. The risk of disease.
5. 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 decreased risk of cardiovascular disease in newly diagnosed type 2 diabetic patients and type 2 diabetic patients who have already developed cardiovascular disease.
6. 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 different degrees of hyperinsulinemia. Studies have shown that metformin can reduce insulin resistance, restore its ovulation function, and improve hyperandrogenemia.
7. Improve intestinal flora
Studies have shown that metformin can restore the proportion of intestinal flora and make it change in a direction that is conducive to health. It provides an advantageous living environment for the beneficial bacteria in the intestines, thereby lowering blood sugar and positively regulating the immune system.
8. 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 Nature Medicine, a sub-issue of Nature. At present, autism is one of many medical conditions that scientists believe can be treated with metformin.
9. Reverse pulmonary fibrosis
Researchers at the University of Alabama at Birmingham found that in human patients with idiopathic pulmonary fibrosis and mouse pulmonary fibrosis models induced by bleomycin, the activity of AMPK in fibrotic tissues is reduced, and the tissues resist cells The 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.
10. Assist in quitting smoking
Researchers at the University of Pennsylvania have found that long-term nicotine use can lead to the activation of the AMPK signaling pathway, which is inhibited during nicotine withdrawal. Therefore, they concluded that if drugs are used to activate the AMPK signaling pathway, it may 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.
11. Anti-inflammatory effect
Previously, preclinical 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).
12. 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.
13. 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 mouse tumors.
Through further research, it was found that metformin and fasting inhibit tumor growth through the PP2A-GSK3β-MCL-1 pathway. The research was published on Cancer Cell.
14. 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.
15. Or can treat hair loss
The team of Huang Jing, a Chinese scientist at the University of California, Los Angeles, discovered that drugs such as metformin and rapamycin can stimulate the 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.
16. Reverse biological age
Recently, 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.
17. Combination medication may treat triple-negative breast cancer
A few days ago, a team led by Dr. Marsha rich rosner of the University of Chicago discovered 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.
18. May reduce the 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 caused by the 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.