Abstract
Background and AimA growing body of evidence suggests that preadmission metformin use could decrease the mortality of septic patients with diabetes mellitus (DM); however, the findings remain controversial. Therefore, this meta-analysis was conducted on available studies to confirm the relationship between preadmission metformin use and mortality in patients with sepsis and DM.MethodsA comprehensive search of the PubMed, Embase, and Cochrane Library databases was performed for studies published before August 8, 2021. Observational studies assessing the correlation between metformin use and mortality in patients with sepsis and DM were considered eligible studies. We used the Newcastle–Ottawa Scale (NOS) to assess the outcome quality of each included article. Furthermore, the odds ratios (ORs) and 95% confidence intervals (CIs) were analyzed using the inverse variance method with random effects modeling.ResultsEleven articles including 8195 patients were analyzed in this meta-analysis. All the included articles were scored as low risk of bias. Our results showed that preadmission metformin use had a lower mortality rate (OR, 0.74; 95% CIs, 0.62–0.88, P < 0.01) in patients with sepsis and DM. Surprisingly, there was no statistically significant difference in the levels of serum creatinine (weighted mean difference (WMD), 0.36; 95% CIs, −0.03–0.75; P = 0.84) and lactic acid (WMD, −0.16; 95% CIs, −0.49–0.18; P = 0.07) between preadmission metformin use and non-metformin use.ConclusionsThis study is the most comprehensive meta-analysis at present, which shows that preadmission metformin use may reduce mortality and not increase the levels of serum creatinine and lactic acid in adult patients with sepsis and DM. Therefore, these data suggest that the potential efficacy of metformin could be assessed in future clinical studies.Systematic Review Registration https://inplasy.com/?s=INPLASY2021100113, identifier INPLASY2021100113.
Highlights
Sepsis is a life-threatening systemic inflammation characterized by host immune dysfunction and multiple organ damage [1]
As the effects of metformin on mortality are controversial, we investigated the effects of metformin on mortality in patients with sepsis and diabetes mellitus (DM)
After assessing the full-text eligibility, only 32 articles that addressed reasons potentially associated with the original study question remained
Summary
Sepsis is a life-threatening systemic inflammation characterized by host immune dysfunction and multiple organ damage [1]. Inflammatory factors and mediators such as high mobility group protein and nuclear factor-kappa B (NF-kB) may play significant roles in the pathogenesis of sepsis [3, 4]. Studies demonstrated that continual and active inflammatory molecular responses need sufficient metabolic supply. Metformin reduces the inflammatory response in the body, which may reduce mortality in septic patients with diabetes mellitus (DM). A growing body of evidence suggests that preadmission metformin use could decrease the mortality of septic patients with diabetes mellitus (DM); the findings remain controversial.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
