000			03851nam a22006137a 4500
008			240723s20242024 xxu||||| |||| 00| 0 eng d
022			_a0954-691X
024			_a00042737-990000000-00323 [pii]
040			_aOvid MEDLINE(R)
099			_a38477839
245			_aClinical outcomes with metformin use in diabetic patients with compensated cirrhosis: a systematic review and meta-analysis.
251			_aEuropean Journal of Gastroenterology & Hepatology. 36(5):674-682, 2024 May 01.
252			_aEur J Gastroenterol Hepatol. 36(5):674-682, 2024 May 01.
253			_aEuropean journal of gastroenterology & hepatology
260			_c2024
260			_p2024 May 01
260			_fFY2024
265			_sppublish
265			_tMEDLINE
501			_aAvailable online from MWHC library: 2001 - present
520			_aAIM: To investigate the impact of metformin on mortality and hepatic decompensation in people with diabetes with compensated cirrhosis.
520			_aBACKGROUND: Previous studies have demonstrated a beneficial effect of metformin in patients with cirrhosis, but no improvement in liver histology.
520			_aCONCLUSION: Metformin use is associated with reduced all-cause mortality, but not with the prevention of hepatic decompensation in people with diabetes with compensated cirrhosis. The mortality benefit is most likely driven by better diabetes and cardiovascular health control. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
520			_aMETHODS: Medline, Embase and Cochrane databases were searched from inception to February 2023 for studies reporting results regarding the impact of metformin on all-cause mortality and hepatic decompensation in people with diabetes with compensated cirrhosis. The risk of bias was assessed by ROBINS-I Cochrane tool. R software 4.3.1 was used for all analyses.
520			_aRESULTS: Six observational studies were included in the final analysis. Metformin use was associated with reduced all-cause mortality or liver transplantation [hazard ratio (HR): 0.55; 95% confidence interval (CI) 0.37-0.82], while no benefit was shown in the prevention of hepatic decompensation (HR: 0.97; 95% CI: 0.77-1.22). In the subgroup analysis, metformin use was associated with reduced all-cause mortality or liver transplantation (HR: 0.50; 95% CI 0.38-0.65) in patients with metabolic-associated steatohepatitis cirrhosis, while two studies reported no survival benefit in patients with cirrhosis due to hepatitis C (HR: 0.39; 95% CI 0.12-1.20).
546			_aEnglish
650			_a*Diabetes Mellitus
650			_a*Hepatitis C
650			_a*Liver Transplantation
650			_a*Metformin
650			_aDiabetes Mellitus/dt [Drug Therapy]
650			_aDiabetes Mellitus/ep [Epidemiology]
650			_aHepatitis C/dt [Drug Therapy]
650			_aHumans
650			_aLiver Cirrhosis/co [Complications]
650			_aLiver Cirrhosis/di [Diagnosis]
650			_aLiver Cirrhosis/dt [Drug Therapy]
650			_aMetformin/tu [Therapeutic Use]
650			_zAutomated
651			_aMedStar Health Research Institute
651			_aMedStar Washington Hospital Center
656			_aInternal Medicine Residency
656			_aMedStar Georgetown University Hospital/MedStar Washington Hospital Center
657			_aJournal Article
657			_aMeta-Analysis
657			_aSystematic Review
700			_aArafat, Ayah _bMHRI
700			_aChou, JiLing _bMHRI
700			_aDoumas, Stavros _bMGUH _cInternal Medicine Residency _dMD
700			_aPeppas, Spyros _bMWHC _cInternal Medicine Residency _dMD
790			_aPeppas S, Doumas S, Suvarnakar A, Chou J, Arafat A, Ahmad AI, Lewis JH
856			_uhttps://dx.doi.org/10.1097/MEG.0000000000002754 _zhttps://dx.doi.org/10.1097/MEG.0000000000002754
942			_cART _dArticle
999			_c14322 _d14322