Reduced decline of lung diffusing capacity in COPD patients with diabetes and metformin treatment
Kathrin Kahnert, Stefan Andreas, Christina Kellerer, Johanna I. Lutter, Tanja Lucke, Önder Yildirim, Mareike Lehmann, Jochen Seißler, Jürgen Behr, Marion Frankenberger, Robert Bals, Henrik Watz, Tobias Welte, Franziska Trudzinski, Claus Vogelmeier, Peter Alter, Rudolf A. Jörres, COSYCONET Study Group, Stefan Andreas, Robert Bals, Jürgen Behr, Kathrin Kahnert, Thomas Bahmer, Burkhard Bewig, Ralf Ewert, Beate Stubbe, Joachim H. Ficker, Christian Grohé, Held Matthias, Markus Henke, Felix Herth, Anne‐Marie Kirsten, Henrik Watz, Rembert Koczulla, Kronsbein Juliane, Cornelia Kropf-Sanchen, Christian Herzmann, Michael Pfeifer, Winfried Randerath, Werner Seeger, Michael Studnicka, Christian Taube, Hartmut Timmermann, Peter Alter, Bernd Schmeck, Claus Vogelmeier, Tobias Welte, Hubert Wirtz
Abstract
Abstract We studied whether in patients with COPD the use of metformin for diabetes treatment was linked to a pattern of lung function decline consistent with the hypothesis of anti-aging effects of metformin. Patients of GOLD grades 1–4 of the COSYCONET cohort with follow-up data of up to 4.5 y were included. The annual decline in lung function (FEV 1 , FVC) and CO diffusing capacity (KCO, TLCO) in %predicted at baseline was evaluated for associations with age, sex, BMI, pack-years, smoking status, baseline lung function, exacerbation risk, respiratory symptoms, cardiac disease, as well as metformin-containing therapy compared to patients without diabetes and metformin. Among 2741 patients, 1541 (mean age 64.4 y, 601 female) fulfilled the inclusion criteria. In the group with metformin treatment vs. non-diabetes the mean annual decline in KCO and TLCO was significantly lower (0.2 vs 2.3, 0.8 vs. 2.8%predicted, respectively; p < 0.05 each), but not the decline of FEV 1 and FVC. These results were confirmed using multiple regression and propensity score analyses. Our findings demonstrate an association between the annual decline of lung diffusing capacity and the intake of metformin in patients with COPD consistent with the hypothesis of anti-aging effects of metformin as reflected in a surrogate marker of emphysema.