Cardiovascular Outcome And Metformin Therapy In The Management Of T2DM,T2DM And HF,T2DM And MI:Meta-analysis Of Published Observational Studies And Erdheim-chester Disease:a Case Report

Background:Metformin was recommended as the first-line agent for diabetes mellitus2 since publication of the results of the UK Prospective Diabetes Study(UKPDS 34)in 19981.We aimed to evaluate the risk of cardiovascular morbidity and mortality of metformin in patients with T2DM,as while as patients with T2DM and HF,and patients with T2DM and AMILMethods:We used Pubmed,Embase,and Cochrane Library as the basic databases for searching studies in this article.We calculated the relative risks(RRs)and 95%CI of all-cause mortality,HF and AMI to evaluate the association between metformin and morbidity and mortality.Results:Among patients with T2DM,when compared sulfonylurea with metformin,the RR(95%CI)of all-cause mortality was 1.62(1.24-2.12).And sulfonylurea increased the risk of HF and AMI when compared with metformin,the RRs(95%CI)were 1.42(1.33-1.51)and 1.41(1.04-1.90).And rosiglitazone were associated with increasing the risk of AMI and HF when compared with metformin,the RRs(95%Cl)were 1.44(1.01-2.06)and 1.42(1.24-1.63).In patients with T2DM and HF,metformin was associated with reducing the mortality when compared with controls,The RR(95%CI)was 0.84(0.81-0.87).Information on other comparisons was scarce and heterogeneity can be decreased by sensitivity analyses in most comparisons.Conclusions:In patients with T2DM and in patients with T2DM and HF,metformin was a safe choose for glycemic control.And there was no statistically significant association between metformin and cardiovascular protection in patients with T2DM and AMI.Background:Erdheim-Chester disease is a rare illness,which is hard to diagnosis and treatment,and required more attention.Methods:We report a case of a 34 years old woman,who presented with palpitation,eye convex and skelalgia and be diagnosed of Erdheim-Chester disease by imaging studies and histopathological observation.Results:With our patient,we have found some observations of eye,bone,cardiovascular and breasr disorder in ECD.Conclusion:At present,Erdheim-Chester disease can be diagnosed by imaging studies and histopathological observation,but no therapy is available.We should pay more attention on the understanding and therapy of this disease.