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Metformin use correlated with lower risk of cardiometabolic diseases and related mortality among US cancer survivors: evidence from a nationally representative cohort study

dc.contributor.authorYukun Li
dc.contributor.authorXiaoying Liu
dc.contributor.authorWenhe Lv
dc.contributor.authorXuesi Wang
dc.contributor.authorZhuohang Du
dc.contributor.authorXinmeng Liu
dc.contributor.authorFanchao Meng
dc.contributor.authorShuqi Jin
dc.contributor.authorSongnan Wen
dc.contributor.authorRong Bai
dc.contributor.authorNian Liu
dc.contributor.authorRibo Tang
dc.contributor.otherDepartment of Cardiology, Beijing Anzhen Hospital, Capital Medical University
dc.contributor.otherDepartment of Cardiology, Beijing Anzhen Hospital, Capital Medical University
dc.contributor.otherDepartment of Cardiology, Beijing Anzhen Hospital, Capital Medical University
dc.contributor.otherDepartment of Cardiology, Beijing Anzhen Hospital, Capital Medical University
dc.contributor.otherDepartment of Cardiology, Beijing Anzhen Hospital, Capital Medical University
dc.contributor.otherDepartment of Cardiology, Beijing Anzhen Hospital, Capital Medical University
dc.contributor.otherDepartment of Cardiology, Beijing Anzhen Hospital, Capital Medical University
dc.contributor.otherDepartment of Cardiology, Beijing Anzhen Hospital, Capital Medical University
dc.contributor.otherDepartment of Cardiovascular Medicine, Mayo Clinic
dc.contributor.otherBanner University Medical Center Phoenix, College of Medicine University of Arizona
dc.contributor.otherDepartment of Cardiology, Beijing Anzhen Hospital, Capital Medical University
dc.contributor.otherDepartment of Cardiology, Beijing Anzhen Hospital, Capital Medical University
dc.date.accessioned2024-06-30T11:24:02Z
dc.date.accessioned2025-10-08T08:27:24Z
dc.date.available2025-10-08T08:27:24Z
dc.date.issued01-06-2024
dc.identifier.urihttp://digilib.fisipol.ugm.ac.id/repo/handle/15717717/35954
dc.description.abstractAbstract Background In the USA, the prolonged effective survival of cancer population has brought significant attention to the rising risk of cardiometabolic morbidity and mortality in this population. This heightened risk underscores the urgent need for research into effective pharmacological interventions for cancer survivors. Notably, metformin, a well-known metabolic regulator with pleiotropic effects, has shown protective effects against cardiometabolic disorders in diabetic individuals. Despite these promising indications, evidence supporting its efficacy in improving cardiometabolic outcomes in cancer survivors remains scarce. Methods A prospective cohort was established using a nationally representative sample of cancer survivors enrolled in the US National Health and Nutrition Examination Survey (NHANES), spanning 2003 to 2018. Outcomes were derived from patient interviews, physical examinations, and public-access linked mortality archives up to 2019. The Oxidative Balance Score was utilized to assess participants’ levels of oxidative stress. To evaluate the correlations between metformin use and the risk of cardiometabolic diseases and related mortality, survival analysis of cardiometabolic mortality was performed by Cox proportional hazards model, and cross-sectional analysis of cardiometabolic diseases outcomes was performed using logistic regression models. Interaction analyses were conducted to explore the specific pharmacological mechanism of metformin. Results Among 3995 cancer survivors (weighted population, 21,671,061, weighted mean [SE] age, 62.62 [0.33] years; 2119 [53.04%] females; 2727 [68.26%] Non-Hispanic White individuals), 448 reported metformin usage. During the follow-up period of up to 17 years (median, 6.42 years), there were 1233 recorded deaths, including 481 deaths from cardiometabolic causes. Multivariable models indicated that metformin use was associated with a lower risk of all-cause (hazard ratio [HR], 0.62; 95% confidence interval [CI], 0.47–0.81) and cardiometabolic (HR, 0.65; 95% CI, 0.44–0.97) mortality compared with metformin nonusers. Metformin use was also correlated with a lower risk of total cardiovascular disease (odds ratio [OR], 0.41; 95% CI, 0.28–0.59), stroke (OR, 0.44; 95% CI, 0.26–0.74), hypertension (OR, 0.27; 95% CI, 0.14–0.52), and coronary heart disease (OR, 0.41; 95% CI, 0.21–0.78). The observed inverse associations were consistent across subgroup analyses in four specific cancer populations identified as cardiometabolic high-risk groups. Interaction analyses suggested that metformin use as compared to non-use may counter-balance oxidative stress. Conclusions In this cohort study involving a nationally representative population of US cancer survivors, metformin use was significantly correlated with a lower risk of cardiometabolic diseases, all-cause mortality, and cardiometabolic mortality.
dc.language.isoEN
dc.publisherBMC
dc.subject.lccMedicine
dc.titleMetformin use correlated with lower risk of cardiometabolic diseases and related mortality among US cancer survivors: evidence from a nationally representative cohort study
dc.typeArticle
dc.description.keywordsCardiometabolic disease
dc.description.keywordsCancer
dc.description.keywordsCardio-oncology
dc.description.keywordsMetformin
dc.description.keywordsOxidative stress
dc.description.pages1-16
dc.description.doi10.1186/s12916-024-03484-y
dc.title.journalBMC Medicine
dc.identifier.e-issn1741-7015
dc.identifier.oai1475126fa2714cebbddfdf9d4be113b5
dc.journal.infoVolume 22, Issue 1


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