Background

In the past few years, an increasing number of studies have proposed the idea of extending the therapeutic range of metformin from traditional hypoglycaemic to autoimmune diseases, and confirmed in a variety of autoimmune diseases. However, whether metformin can be used to treat Hashimoto’s thyroiditis (HT), which is characterised by thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb), is unknown. Therefore, we conducted a systematic review and meta-analysis to evaluate whether metformin can reduce the levels of TPOAb and TgAb in patients with HT or subclinical hypothyroidism (SH), so as to provide a theoretical basis for metformin treatment of these diseases.

Methods

PubMed, Web Of Science and Embase were searched for observational studies investigating the changes of TPOAb and TgAb in patients with HT after metformin treatment. Two authors extracted data from eligible studies and classified them as HT and subclinical hypothyroidism subgroups. The calculation was then performed by weighted mean difference (WMD) combined with a fixed-effects model analysis or standard mean difference (SMD) with a random-effects model analysis, based on the measurement of the outcome.

Results

Metformin significantly reduced TPOAb levels and TgAb levels in patients with HT and SH, especially TPOAb (HT: p _TPOAb = .009, p _TgAb = .046; SH: p _TPOAb = .034, p _TgAb = .066). In addition, metformin also reduced the levels of thyroid stimulating hormone (TSH), homeostasis model assessment of insulin resistance (HOMA-IR) in patients with HT and SH (HT: p _TSH = .000 and p _HOMA-IR = .000; SH: p _TSH = .000 and p _HOMA-IR = .000, respectively).

Conclusion

Metformin significantly reduces TPOAb level and TgAb level in patients with HT and SH, especially TPOAb. This study is the first to provide a preliminary theoretical basis for the clinical application of metformin in the treatment of HT.

中文翻译：

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二甲双胍可降低桥本甲状腺炎患者的自身免疫抗体水平：系统评价和荟萃分析。

背景

在过去的几年中，越来越多的研究提出了将二甲双胍的治疗范围从传统的降血糖疾病扩展到自身免疫疾病的想法，并已在多种自身免疫疾病中得到证实。但是，是否可以将二甲双胍用于治疗以甲状腺过氧化物酶抗体（TPOAb）和甲状腺球蛋白抗体（TgAb）为特征的桥本甲状腺炎（HT）。因此，我们进行了系统的综述和荟萃分析，以评估二甲双胍是否可以降低HT或亚临床甲状腺功能减退症（SH）患者的TPOAb和TgAb水平，从而为二甲双胍治疗这些疾病提供理论依据。

方法

搜索PubMed，Web of Science和Embase进行观察性研究，以调查二甲双胍治疗后HT患者TPOAb和TgAb的变化。两位作者从符合条件的研究中提取了数据，并将其分类为HT和亚临床甲状腺功能减退症亚组。然后根据结果的测量结果，通过加权平均差（WMD）与固定效果模型分析或标准平均差（SMD）与随机效果模型分析相结合进行计算。

结果

二甲双胍显着降低了HT和SH患者的TPOAb和TgAb水平，尤其是TPOAb（HT：p _TPOAb = .009 ，p _TgAb = .046; SH：p _TPOAb = .034 ，p _TgAb = .066）。此外，二甲双胍还降低了HT和SH患者的甲状腺刺激激素（TSH）水平，胰岛素抵抗稳态模型评估（HOMA-IR）（HT：p _TSH = .000和p _HOMA-IR = .000； SH：p _TSH = .000和p _HOMA-IR = .000）。

结论

二甲双胍可显着降低HT和SH患者的TPOAb和TgAb水平，尤其是TPOAb。这项研究首次为二甲双胍在HT治疗中的临床应用提供了初步的理论基础。