近日，武汉大学等研究人员合作发现，在感染COVID-19的2型糖尿病患者中，二甲双胍的使用与酸中毒的发生率增加相关，但与死亡率无关。2020年8月20日，《细胞—代谢》在线发表了这一成果。

研究人员对1213例感染COVID-19的2型糖尿病（T2D）患者进行了回顾性研究，并发现二甲双胍的使用与酸中毒的发生率显著相关，特别是在严重COVID-19的情况下，但与28天内COVID-19相关的死亡率无关。

此外，二甲双胍的使用与心力衰竭和炎症的减少显著相关。这些发现提供了支持在感染COVID-19的T2D患者中继续使用二甲双胍治疗的临床证据，但是在严重COVID-19患者中应仔细监测酸中毒和肾功能。

据介绍，抗糖尿病药的安全性和有效性对于最大限度地控制感染COVID-19的T2D患者的血糖至关重要。二甲双胍是T2D最常用的一线药物，但其对COVID-19和T2D患者预后的影响尚待阐明。

附：英文原文

Title: Metformin Use Is Associated with Increased Incidence of Acidosis but not Mortality in Individuals with COVID-19 and Pre-existing Type 2 Diabetes

Author: Xu Cheng, Ye-Mao Liu, Haomiao Li, Xin Zhang, Fang Lei, Juan-Juan Qin, Ze Chen, Ke-Qiong Deng, Lijin Lin, Ming-Ming Chen, Xiaohui Song, Meng Xia, Xuewei Huang, Weifang Liu, Jingjing Cai, Xiao-Jing Zhang, Feng Zhou, Peng Zhang, Yibin Wang, Xinliang Ma, Qingbo Xu, Juan Yang, Ping Ye, Weiming Mao, Xiaodong Huang, Jiahong Xia, Bing-Hong Zhang, Jiao Guo, Lihua Zhu, Zhibing Lu, Yufeng Yuan, Xiang Wei, Zhi-Gang She, Yan-Xiao Ji, Hongliang Li

Issue&Volume: 2020-08-20

Abstract: The safety and efficacy of anti-diabetic drugs are critical for maximizing the benefical impacts of well-controlled blood glucose on the prognosis of individuals with COVID-19 and pre-existing type 2 diabetes (T2D). Metformin is the most commonly prescribed first-line medication for T2D, but its impact on the outcomes of individuals with COVID-19 and T2D remains to be clarified. Our current retrospective study in a cohort of 1,213 hospitalized individuals with COVID-19 and pre-existing T2D indicated that metformin use was significantly associated with a higher incidence of acidosis, particularly in cases with severe COVID-19, but not with 28-day COVID-19-related mortality. Furthermore, metformin use was significantly associated with reduced heart failure and inflammation. Our findings provide clinical evidence in support of continuing metformin treatment in individuals with COVID-19 and pre-existing T2D, but acidosis and kidney function should be carefully monitored in individuals with severe COVID-19.

DOI: 10.1016/j.cmet.2020.08.013

Source: https://www.cell.com/cell-metabolism/fulltext/S1550-4131(20)30426-5