JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE) ›› 2021, Vol. 41 ›› Issue (4): 473-478.doi: 10.3969/j.issn.1674-8115.2021.04.009
• Clinical research • Previous Articles Next Articles
Shi-kai GENG1(), Le ZHANG2,3(), Hui-jing WANG1, Liang-jing LÜ3, Wei-guo WAN4, Fang-fang SUN1(), Shuang YE1()
Received:
2020-05-28
Online:
2021-04-28
Published:
2021-05-14
Contact:
Fang-fang SUN,Shuang YE
E-mail:shikai_geng@126.com;joyce66dbl@hotmail.com;fiona_rj@163.com;ye_shuang2000@163.com
Supported by:
CLC Number:
Shi-kai GENG, Le ZHANG, Hui-jing WANG, Liang-jing LÜ, Wei-guo WAN, Fang-fang SUN, Shuang YE. Effect of metformin on infection event reduction in patients with systemic lupus erythematosus:a post-hoc analysis of a Met-Lupus Trial[J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2021, 41(4): 473-478.
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URL: https://xuebao.shsmu.edu.cn/EN/10.3969/j.issn.1674-8115.2021.04.009
Indicator | With infection (n=49) | Without infection (n=91) | P value |
---|---|---|---|
Female/n(%) | 45 (91.8) | 86 (94.5) | 0.539 |
Age/year | 35.1±12.8 | 32.1±10.9 | 0.255 |
Disease duration/year | 5.2±5.3 | 4.5±3.7 | 0.779 |
BMI/(kg·m-2) | 23.5±4.0 | 22.7±3.5 | 0.221 |
Complication/n(%) | 10 (20.4) | 21 (23.1) | 0.717 |
Lupus nephritis | 6 (12.2) | 16 (17.6) | 0.408 |
Immune thrombocytopenia | 2 (4.1) | 3 (3.3) | 0.811 |
Antiphospholipid syndrome | 1 (2.0) | 1 (1.1) | 0.666 |
Pulmonary hypertension | 1 (2.0) | 1 (1.1) | 0.666 |
SELENA-SLEDAI | 2.4±1.8 | 2.7±1.6 | 0.481 |
Laboratory result | |||
White blood cell/(×109·L-1) | 6.0 (4.7, 8.0) | 5.4 (4.2, 7.3) | 0.270 |
Neutrophil/(×109·L-1) | 4.2±2.2 | 3.9±1.9 | 0.428 |
Lymphocyte/(×109·L-1) | 1.4 (1.0, 1.9) | 1.5 (1.1, 2.0) | 0.317 |
Hemoglobin/(g·L-1) | 127.3±14.0 | 125.6±21.7 | 0.810 |
Platelet/(×109·L-1) | 223.5 (159.5, 270.0) | 213.0 (162.8, 263.5) | 0.814 |
ESR/(mm·h-1) | 11.0 (7.0, 28.0) | 13.0 (5.3, 30.0) | 0.641 |
CRP/(mg·L-1) | 2.5 (2.0, 4.3) | 2.5 (1.0, 4.0) | 0.694 |
GPT /(U·L-1) | 16.4±11.7 | 20.5±16.2 | 0.203 |
Serum creatinine/ (μmol·L-1) | 57.9±9.4 | 57.9±12.6 | 0.784 |
Anti-dsDNA antibody/ (IU·mL-1) | 22.0 (4.3, 53.1) | 30.0 (14.7, 87.5) | 0.176 |
Complement 3/(g·L-1) | 0.8±0.3 | 0.8±0.2 | 0.782 |
Complement 4/(g·L-1) | 0.2±0.0 | 0.1±0.1 | 0.161 |
IgG/(g·L-1) | 13.9±4.8 | 14.5±5.5 | 0.703 |
IgM/(g·L-1) | 0.7±1.3 | 0.5±0.6 | 0.856 |
IgA/(g·L-1) | 2.9±2.1 | 2.3±1.4 | 0.171 |
Medication | |||
Prednisone/(mg·d-1) | 10.0 (7.5, 15.0) | 10.0 (6.3, 15.0) | 0.914 |
Hydroxychloroquine/n (%) | 44 (89.8) | 82 (90.1) | 0.539 |
Immunosuppressants/n (%) | 33 (67.4) | 60 (65.9) | 0.866 |
Azathioprine | 2 (4.1) | 7 (7.7) | 0.406 |
Mycophenolate | 18 (36.7) | 29 (31.9) | 0.561 |
Calcineurin inhibitor | 4 (8.2) | 6 (6.6) | 0.731 |
Methotrexate | 8 (16.3) | 16 (17.6) | 0.851 |
Leflunomide | 1 (2.0) | 2 (2.2) | 0.951 |
Metformin/n(%) | 17 (34.7) | 50 (65.9) | 0.022 |
Tab 1 Comparison of baseline characteristics and medication between the participants with and without infection
Indicator | With infection (n=49) | Without infection (n=91) | P value |
---|---|---|---|
Female/n(%) | 45 (91.8) | 86 (94.5) | 0.539 |
Age/year | 35.1±12.8 | 32.1±10.9 | 0.255 |
Disease duration/year | 5.2±5.3 | 4.5±3.7 | 0.779 |
BMI/(kg·m-2) | 23.5±4.0 | 22.7±3.5 | 0.221 |
Complication/n(%) | 10 (20.4) | 21 (23.1) | 0.717 |
Lupus nephritis | 6 (12.2) | 16 (17.6) | 0.408 |
Immune thrombocytopenia | 2 (4.1) | 3 (3.3) | 0.811 |
Antiphospholipid syndrome | 1 (2.0) | 1 (1.1) | 0.666 |
Pulmonary hypertension | 1 (2.0) | 1 (1.1) | 0.666 |
SELENA-SLEDAI | 2.4±1.8 | 2.7±1.6 | 0.481 |
Laboratory result | |||
White blood cell/(×109·L-1) | 6.0 (4.7, 8.0) | 5.4 (4.2, 7.3) | 0.270 |
Neutrophil/(×109·L-1) | 4.2±2.2 | 3.9±1.9 | 0.428 |
Lymphocyte/(×109·L-1) | 1.4 (1.0, 1.9) | 1.5 (1.1, 2.0) | 0.317 |
Hemoglobin/(g·L-1) | 127.3±14.0 | 125.6±21.7 | 0.810 |
Platelet/(×109·L-1) | 223.5 (159.5, 270.0) | 213.0 (162.8, 263.5) | 0.814 |
ESR/(mm·h-1) | 11.0 (7.0, 28.0) | 13.0 (5.3, 30.0) | 0.641 |
CRP/(mg·L-1) | 2.5 (2.0, 4.3) | 2.5 (1.0, 4.0) | 0.694 |
GPT /(U·L-1) | 16.4±11.7 | 20.5±16.2 | 0.203 |
Serum creatinine/ (μmol·L-1) | 57.9±9.4 | 57.9±12.6 | 0.784 |
Anti-dsDNA antibody/ (IU·mL-1) | 22.0 (4.3, 53.1) | 30.0 (14.7, 87.5) | 0.176 |
Complement 3/(g·L-1) | 0.8±0.3 | 0.8±0.2 | 0.782 |
Complement 4/(g·L-1) | 0.2±0.0 | 0.1±0.1 | 0.161 |
IgG/(g·L-1) | 13.9±4.8 | 14.5±5.5 | 0.703 |
IgM/(g·L-1) | 0.7±1.3 | 0.5±0.6 | 0.856 |
IgA/(g·L-1) | 2.9±2.1 | 2.3±1.4 | 0.171 |
Medication | |||
Prednisone/(mg·d-1) | 10.0 (7.5, 15.0) | 10.0 (6.3, 15.0) | 0.914 |
Hydroxychloroquine/n (%) | 44 (89.8) | 82 (90.1) | 0.539 |
Immunosuppressants/n (%) | 33 (67.4) | 60 (65.9) | 0.866 |
Azathioprine | 2 (4.1) | 7 (7.7) | 0.406 |
Mycophenolate | 18 (36.7) | 29 (31.9) | 0.561 |
Calcineurin inhibitor | 4 (8.2) | 6 (6.6) | 0.731 |
Methotrexate | 8 (16.3) | 16 (17.6) | 0.851 |
Leflunomide | 1 (2.0) | 2 (2.2) | 0.951 |
Metformin/n(%) | 17 (34.7) | 50 (65.9) | 0.022 |
Factor | β value | Standard error | Wald value | P value | OR (95%CI) |
---|---|---|---|---|---|
Gender | 0.176 | 0.818 | 0.046 | 0.829 | 1.193 (0.240-5.930) |
Age | 0.018 | 0.017 | 1.123 | 0.289 | 1.018 (0.985-1.053) |
SELENA-SLEDAI | 0.125 | 0.133 | 0.876 | 0.349 | 1.133 (0.872-1.471) |
Neutrophil | 0.025 | 0.110 | 0.053 | 0.818 | 1.026 (0.827-1.272) |
Prednisone | -0.022 | 0.035 | 0.381 | 0.537 | 0.979 (0.914-1.048) |
Use of hydroxychloroquine | 1.014 | 0.826 | 1.506 | 0.220 | 2.755 (0.546-13.905) |
Use of metformin | -0.860 | 0.404 | 4.536 | 0.033 | 0.423 (0.192-0.934) |
Tab 2 Multivariate Logistic regression analysis of the participants with infection
Factor | β value | Standard error | Wald value | P value | OR (95%CI) |
---|---|---|---|---|---|
Gender | 0.176 | 0.818 | 0.046 | 0.829 | 1.193 (0.240-5.930) |
Age | 0.018 | 0.017 | 1.123 | 0.289 | 1.018 (0.985-1.053) |
SELENA-SLEDAI | 0.125 | 0.133 | 0.876 | 0.349 | 1.133 (0.872-1.471) |
Neutrophil | 0.025 | 0.110 | 0.053 | 0.818 | 1.026 (0.827-1.272) |
Prednisone | -0.022 | 0.035 | 0.381 | 0.537 | 0.979 (0.914-1.048) |
Use of hydroxychloroquine | 1.014 | 0.826 | 1.506 | 0.220 | 2.755 (0.546-13.905) |
Use of metformin | -0.860 | 0.404 | 4.536 | 0.033 | 0.423 (0.192-0.934) |
Indicator | Metformin (n=17) | Placebo (n=32) | P value |
---|---|---|---|
Female/n(%) | 15 (88.2) | 30 (93.8) | 0.502 |
Age/year | 36.6±14.4 | 34.3±12.0 | 0.634 |
Disease duration/year | 5.2±5.8 | 5.1±5.0 | 0.846 |
BMI/(kg·m-2) | 22.1±3.1 | 24.3±4.1 | 0.056 |
SELENA-SLEDAI | 2.4±1.7 | 3.1±2.1 | 0.184 |
Laboratory result | |||
White blood cell/ (×109·L-1) | 5.9 (4.52, 7.5) | 6.0 (4.5, 7.3) | 0.852 |
Neutrophil/(×109·L-1) | 4.7±2.3 | 5.5±1.9 | 0.446 |
Platelet/(×109·L-1) | 223.5 (159.5, 267.3) | 230.5 (176.5, 276.8) | 0.582 |
ESR/(mm·h-1) | 25.5 (10.5, 44.5) | 17.0 (7.3, 30.8) | 0.185 |
CRP/(mg·L-1) | 2.5 (2.4, 6.4) | 4.5 (2.5, 8.9) | 0.075 |
Anti-dsDNA antibody/ (IU·mL-1) | 23.0 (4.5, 34.1) | 22.0 (3.0, 62.2) | 0.622 |
Complement 3/(g·L-1) | 0.9±0.3 | 0.8±0.2 | 0.087 |
Complement 4/(g·L-1) | 0.2±0.1 | 0.2±0.1 | 0.112 |
IgG/(g·L-1) | 3.3±1.9 | 2.9±2.5 | 0.997 |
IgM/(g·L-1) | 17.9±10.0 | 15.8±7.5 | 0.331 |
IgA/(g·L-1) | 1.2±0.6 | 1.0±0.4 | 0.746 |
Medication | |||
Prednisone/(mg·d-1) | 5.0 (3.8, 7.5) | 6.9 (5.0, 12.5) | 0.084 |
Hydroxychloroquine/n (%) | 15 (88.2) | 29 (90.6) | 0.793 |
Immunosuppressants/n (%) | 13 (76.5) | 20 (62.5) | 0.321 |
Infection duration/d | 7.0 (6.0, 11.8) | 10.0 (7.0, 21.8) | 0.034 |
Infection/n (%) | 0.466 | ||
Severe infection | 1 (5.9) | 4 (12.5) | |
Mild infection | 16 (94.1) | 28 (87.5) |
Tab 3 Comparison of clinical characteristics and SLE medication of participants in metformin group and placebo group during infection
Indicator | Metformin (n=17) | Placebo (n=32) | P value |
---|---|---|---|
Female/n(%) | 15 (88.2) | 30 (93.8) | 0.502 |
Age/year | 36.6±14.4 | 34.3±12.0 | 0.634 |
Disease duration/year | 5.2±5.8 | 5.1±5.0 | 0.846 |
BMI/(kg·m-2) | 22.1±3.1 | 24.3±4.1 | 0.056 |
SELENA-SLEDAI | 2.4±1.7 | 3.1±2.1 | 0.184 |
Laboratory result | |||
White blood cell/ (×109·L-1) | 5.9 (4.52, 7.5) | 6.0 (4.5, 7.3) | 0.852 |
Neutrophil/(×109·L-1) | 4.7±2.3 | 5.5±1.9 | 0.446 |
Platelet/(×109·L-1) | 223.5 (159.5, 267.3) | 230.5 (176.5, 276.8) | 0.582 |
ESR/(mm·h-1) | 25.5 (10.5, 44.5) | 17.0 (7.3, 30.8) | 0.185 |
CRP/(mg·L-1) | 2.5 (2.4, 6.4) | 4.5 (2.5, 8.9) | 0.075 |
Anti-dsDNA antibody/ (IU·mL-1) | 23.0 (4.5, 34.1) | 22.0 (3.0, 62.2) | 0.622 |
Complement 3/(g·L-1) | 0.9±0.3 | 0.8±0.2 | 0.087 |
Complement 4/(g·L-1) | 0.2±0.1 | 0.2±0.1 | 0.112 |
IgG/(g·L-1) | 3.3±1.9 | 2.9±2.5 | 0.997 |
IgM/(g·L-1) | 17.9±10.0 | 15.8±7.5 | 0.331 |
IgA/(g·L-1) | 1.2±0.6 | 1.0±0.4 | 0.746 |
Medication | |||
Prednisone/(mg·d-1) | 5.0 (3.8, 7.5) | 6.9 (5.0, 12.5) | 0.084 |
Hydroxychloroquine/n (%) | 15 (88.2) | 29 (90.6) | 0.793 |
Immunosuppressants/n (%) | 13 (76.5) | 20 (62.5) | 0.321 |
Infection duration/d | 7.0 (6.0, 11.8) | 10.0 (7.0, 21.8) | 0.034 |
Infection/n (%) | 0.466 | ||
Severe infection | 1 (5.9) | 4 (12.5) | |
Mild infection | 16 (94.1) | 28 (87.5) |
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