Collocation of metformin and dipeptidyl peptidase-4 inhibitor is associated with increased risk of diabetes-related vascular dementia: A single hospital study in Northern Taiwan

ABSTRACT

Background

Recent studies have established a close link between diabetes mellitus (DM) and an increased risk of vascular dementia (VD). In this study, we evaluated the risk of VD in patients with type 2 diabetes who were on antidiabetic medications.

Methods

There is a growing interest in observational and data-driven studies to answer specific research questions for defined populations. In line with this, 67,281 patients (age range, 61.95 ± 13.88 years; length of follow up, 3.2 ± 3.4 years) diagnosed with DM were divided into two groups:48,072 subjects who had not used dipeptidyl peptidase-4 (DPP-4) medication and 19,209 subjects who had taken DPP-4 medication. Each patient underwent follow-up examination after the date of the latest diagnosis.

Results

Among 10,884 DM patients with dementia, the combination therapy of metformin and DPP-4 inhibitor may increase the risk of dementia compared with that in the control group (adjusted hazard ratio, 1.11; 95% confidence interval, 1.06–1.15; p ≤ 0.001).

Conclusion

In this study, patients who received a combination therapy of metformin and DPP-4 inhibitor for DM were at a higher risk of dementia than those who received monotherapy.

KEYWORDS:

• Vascular dementia
• diabetes mellitus
• dipeptidyl peptidase 4 inhibitors
• metformin
• risk factors

Acknowledgments

The authors thank the Ms. Chi Chun Chang who provided technical support for AICS EMR Lumos system in the study.

Declaration of interests

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contribution statement

IS Tzeng proposed the research idea, wrote the results and discussion section, and contributed to the literature review. TH Hsieh performed analyses. IS Tzeng supported data analysis and prepared the manuscript for submission. All authors have read and approved the final manuscript.

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Ethical disclosure statement

The EMR study was approved by the Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation Institutional Review Board (Protocol Number: 09-X-007; 10-XD-111). The need for informed consent was waived by the Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation Institutional Review Board.

Additional information

Funding

This study was funded by Taipei Tzu Chi Hospital; grant number TCRD-TPE-111-08 (2/2).