A influência da metformina no declínio neurocognitivo: uma revisão sistemática com metanálise

Abstract

Background: Blood glucose variations are generally associated with predisposition to the development of dementia in diabetes patients. And there is a controversy in the literature about whether the use of antihyperglycemic agents can(not) promote protective effects on cognition. Design and setting: we used a systematic review with meta-analysis to evaluate whether the evidence in the literature points to a protective or harmful effect of antihyperglycemic agents on cognition. Methods: PubMed, Science Direct and Scielo databases were used to collect articles in English, published between 2005 and 2020. Articles of reflection/opinion, monographs/theses/dissertations, and animal research were excluded. The blinding of authors during the searches contributed to search independence. Of 1,329 articles selected, 30 were adequate, but only 3 of these provided quantitative data from 53 cognitive tests, which were used for meta-analysis (random effect model), performed using R. Results: Funnel plot shows no publication bias. Forest plot, on the other hand, shows that literature points to the use of antihyperglycemic agents by patients as preventive of cognitive losses (standard mean difference equal to -0.18 [95% confidence interval between -0.29 and -0.06]). Conclusion: Evidence of the preventive effect of cognitive losses through the use of antihyperglycemic agents such as metformin should be further investigated, in order to better clarify this therapeutic potential.