Differential effects of metformin on age related comorbidities in older men with type 2 diabetes

Chen-pin Wang, Carlos Lorenzo, Samy L Habib, Booil Jo, Sara E Espinoza

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Aims: To identify distinct temporal likelihoods of age-related comorbidity (ARC) diagnoses: cardiovascular diseases (CVD), cancer, depression, dementia, and frailty-related diseases (FRD) in older men with type 2 diabetes (T2D) but ARC naïve initially, and assess the heterogeneous effects of metformin on ARCs and mortality. Methods: We identified a clinical cohort of male veterans in the United States who were ≥. 65. years old with T2D and free from ARCs during 2002-2003. ARC diagnoses during 2004-2012 were analyzed using latent class modeling adjusted for confounders. Results: The cohort consisted of 41,204 T2D men with age 74.6. ±. 5.8. years, HbA1c 6.5. ±. 0.97%, and 8393 (20.4%) metformin users. Four ARC classes were identified. 'Healthy Class' (53.6%): metformin reduced likelihoods of all ARCs (from 0.14% in dementia to 6.1% in CVD). 'High Cancer Risk Class' (11.6%): metformin reduced likelihoods of CVD (13.3%), cancer (45.5%), depression (5.0%), and FRD (13.7%). 'High CVD Risk Class' (17.4%): metformin reduced likelihoods of CVD (48.6%), cancer (3.2%), depression (2.8%), and FRD (6.3%). 'High Frailty Risk Class' (17.2%): metformin reduced likelihoods of CVD (18.8%), cancer (3.9%), dementia (3.8%), depression (15.6%), and FRD (23.8%). Conclusions: Metformin slowed ARC development in old men with T2D, and these effects varied by ARC phenotype.

Original languageEnglish (US)
JournalJournal of Diabetes and its Complications
DOIs
StateAccepted/In press - Nov 7 2016

Fingerprint

Metformin
Type 2 Diabetes Mellitus
Comorbidity
Cardiovascular Diseases
AIDS-Related Complex
Depression
Dementia
Neoplasms
Veterans
Phenotype
Mortality

Keywords

  • Comorbidity
  • Frailty
  • Metformin
  • Mortality
  • Type 2 diabetes

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Differential effects of metformin on age related comorbidities in older men with type 2 diabetes. / Wang, Chen-pin; Lorenzo, Carlos; Habib, Samy L; Jo, Booil; Espinoza, Sara E.

In: Journal of Diabetes and its Complications, 07.11.2016.

Research output: Contribution to journalArticle

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title = "Differential effects of metformin on age related comorbidities in older men with type 2 diabetes",
abstract = "Aims: To identify distinct temporal likelihoods of age-related comorbidity (ARC) diagnoses: cardiovascular diseases (CVD), cancer, depression, dementia, and frailty-related diseases (FRD) in older men with type 2 diabetes (T2D) but ARC na{\"i}ve initially, and assess the heterogeneous effects of metformin on ARCs and mortality. Methods: We identified a clinical cohort of male veterans in the United States who were ≥. 65. years old with T2D and free from ARCs during 2002-2003. ARC diagnoses during 2004-2012 were analyzed using latent class modeling adjusted for confounders. Results: The cohort consisted of 41,204 T2D men with age 74.6. ±. 5.8. years, HbA1c 6.5. ±. 0.97{\%}, and 8393 (20.4{\%}) metformin users. Four ARC classes were identified. 'Healthy Class' (53.6{\%}): metformin reduced likelihoods of all ARCs (from 0.14{\%} in dementia to 6.1{\%} in CVD). 'High Cancer Risk Class' (11.6{\%}): metformin reduced likelihoods of CVD (13.3{\%}), cancer (45.5{\%}), depression (5.0{\%}), and FRD (13.7{\%}). 'High CVD Risk Class' (17.4{\%}): metformin reduced likelihoods of CVD (48.6{\%}), cancer (3.2{\%}), depression (2.8{\%}), and FRD (6.3{\%}). 'High Frailty Risk Class' (17.2{\%}): metformin reduced likelihoods of CVD (18.8{\%}), cancer (3.9{\%}), dementia (3.8{\%}), depression (15.6{\%}), and FRD (23.8{\%}). Conclusions: Metformin slowed ARC development in old men with T2D, and these effects varied by ARC phenotype.",
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author = "Chen-pin Wang and Carlos Lorenzo and Habib, {Samy L} and Booil Jo and Espinoza, {Sara E}",
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T1 - Differential effects of metformin on age related comorbidities in older men with type 2 diabetes

AU - Wang, Chen-pin

AU - Lorenzo, Carlos

AU - Habib, Samy L

AU - Jo, Booil

AU - Espinoza, Sara E

PY - 2016/11/7

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N2 - Aims: To identify distinct temporal likelihoods of age-related comorbidity (ARC) diagnoses: cardiovascular diseases (CVD), cancer, depression, dementia, and frailty-related diseases (FRD) in older men with type 2 diabetes (T2D) but ARC naïve initially, and assess the heterogeneous effects of metformin on ARCs and mortality. Methods: We identified a clinical cohort of male veterans in the United States who were ≥. 65. years old with T2D and free from ARCs during 2002-2003. ARC diagnoses during 2004-2012 were analyzed using latent class modeling adjusted for confounders. Results: The cohort consisted of 41,204 T2D men with age 74.6. ±. 5.8. years, HbA1c 6.5. ±. 0.97%, and 8393 (20.4%) metformin users. Four ARC classes were identified. 'Healthy Class' (53.6%): metformin reduced likelihoods of all ARCs (from 0.14% in dementia to 6.1% in CVD). 'High Cancer Risk Class' (11.6%): metformin reduced likelihoods of CVD (13.3%), cancer (45.5%), depression (5.0%), and FRD (13.7%). 'High CVD Risk Class' (17.4%): metformin reduced likelihoods of CVD (48.6%), cancer (3.2%), depression (2.8%), and FRD (6.3%). 'High Frailty Risk Class' (17.2%): metformin reduced likelihoods of CVD (18.8%), cancer (3.9%), dementia (3.8%), depression (15.6%), and FRD (23.8%). Conclusions: Metformin slowed ARC development in old men with T2D, and these effects varied by ARC phenotype.

AB - Aims: To identify distinct temporal likelihoods of age-related comorbidity (ARC) diagnoses: cardiovascular diseases (CVD), cancer, depression, dementia, and frailty-related diseases (FRD) in older men with type 2 diabetes (T2D) but ARC naïve initially, and assess the heterogeneous effects of metformin on ARCs and mortality. Methods: We identified a clinical cohort of male veterans in the United States who were ≥. 65. years old with T2D and free from ARCs during 2002-2003. ARC diagnoses during 2004-2012 were analyzed using latent class modeling adjusted for confounders. Results: The cohort consisted of 41,204 T2D men with age 74.6. ±. 5.8. years, HbA1c 6.5. ±. 0.97%, and 8393 (20.4%) metformin users. Four ARC classes were identified. 'Healthy Class' (53.6%): metformin reduced likelihoods of all ARCs (from 0.14% in dementia to 6.1% in CVD). 'High Cancer Risk Class' (11.6%): metformin reduced likelihoods of CVD (13.3%), cancer (45.5%), depression (5.0%), and FRD (13.7%). 'High CVD Risk Class' (17.4%): metformin reduced likelihoods of CVD (48.6%), cancer (3.2%), depression (2.8%), and FRD (6.3%). 'High Frailty Risk Class' (17.2%): metformin reduced likelihoods of CVD (18.8%), cancer (3.9%), dementia (3.8%), depression (15.6%), and FRD (23.8%). Conclusions: Metformin slowed ARC development in old men with T2D, and these effects varied by ARC phenotype.

KW - Comorbidity

KW - Frailty

KW - Metformin

KW - Mortality

KW - Type 2 diabetes

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