Please use this identifier to cite or link to this item: https://doi.org/10.1038/s41598-018-21612-6
Title: Metformin Use and Severe Dengue in Diabetic Adults
Authors: Htun, H.L
Yeo, T.W
Tam, C.C 
Pang, J 
Leo, Y.S 
Lye, D.C 
Keywords: antidiabetic agent
metformin
adult
aged
classification
complication
dose response
female
human
male
middle aged
non insulin dependent diabetes mellitus
pathology
retrospective study
risk assessment
severe dengue
Singapore
very elderly
Adult
Aged
Aged, 80 and over
Diabetes Mellitus, Type 2
Dose-Response Relationship, Drug
Female
Humans
Hypoglycemic Agents
Male
Metformin
Middle Aged
Retrospective Studies
Risk Assessment
Severe Dengue
Singapore
Issue Date: 2018
Publisher: Nature Publishing Group
Citation: Htun, H.L, Yeo, T.W, Tam, C.C, Pang, J, Leo, Y.S, Lye, D.C (2018). Metformin Use and Severe Dengue in Diabetic Adults. Scientific Reports 8 (1) : 3344. ScholarBank@NUS Repository. https://doi.org/10.1038/s41598-018-21612-6
Rights: Attribution 4.0 International
Abstract: Diabetes mellitus is a risk factor for severe dengue in adults, but few studies have examined the association between metformin use and disease severity in dengue. In addition to its effect on glucose control, metformin has been associated with pleiotropic properties in preclinical studies. Using a cohort of laboratory-confirmed adult (?21 years) dengue patients with diabetes mellitus admitted to Tan Tock Seng Hospital, we conducted a retrospective cohort study involving 131 (58.7%) metformin users and 92 (41.3%) non-users. Dengue severity was categorized as dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS) in World Health Organization (WHO) 1997 criteria and severe dengue (SD) in WHO 2009 criteria. Multivariable Poisson regression with robust error variance was used to estimate risk ratio (RR). Compared with non-use, metformin use was associated with a decreased risk of developing severe dengue (adjusted risk ratio [aRR] = 0.60, 95% confidence interval [CI]: 0.37-0.98, P = 0.04). Additionally, there was an inverse dose-response relationship (aRR = 0.69, 95% CI: 0.49-0.98, P = 0.04) with dengue severity as classified by WHO 2009 criteria. Use of metformin, however, was not associated with dengue severity based on WHO 1997 criteria; and no dose-response relationship was noted. Our results suggest metformin use could attenuate disease severity in dengue-infected diabetes mellitus individuals. © 2018 The Author(s).
Source Title: Scientific Reports
URI: https://scholarbank.nus.edu.sg/handle/10635/178429
ISSN: 2045-2322
DOI: 10.1038/s41598-018-21612-6
Rights: Attribution 4.0 International
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