Overall, metformin can exert protective effects in atherosclerotic thrombotic disease (22, 24), intestinal inflammation (25), cardiovascular disease (31), asthma (26, 27), acute pancreatitis (35), and diabetic nephropathy (28) upon acting on the AMPK/NF-κB, AMPK/PTEN, AMPK/NLRP3, and AMPK/SIRT1 pathways. This evidence concerns the gene PRKAA1 and diabetic kidney disease.