Chin-Hsiao Tseng1,2,3. 1. Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan. 2. Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. 3. Division of Environmental Health and Occupational Medicine of the National Health Research Institutes, Zhunan, Taiwan.
Abstract
OBJECTIVES: To investigate the metformin effect on the risk of osteoporosis (OS) and/or vertebral fracture (VF). METHODS: We enrolled 14 611 pairs of metformin ever and never users matched on propensity score (PS) from Taiwan's National Health Insurance database. All patients had new-onset type 2 diabetes mellitus (T2DM) during 1999-2005 and were free from OS and/or any fracture at the start of follow-up on January 1, 2006. They were followed up until December 31, 2011 for the incidence of OS/VF. Cox regression incorporated with the inverse probability of treatment weighting using PS was used in the main analyses. RESULTS: New-onset OS/VF was diagnosed in 1757 never users (median follow-up 5.0 years) and 1143 ever users (median follow-up 5.3 years). The respective incidence rates were 2870.97 and 1713.20 per 100 000 person-years. Two-thirds of the incident cases had OS without VF and the other third had VF. In main analyses, the hazard ratio for ever vs never users was 0.592 (95% CI: 0.550-0.638). In either sex, a dose-response pattern was noted and metformin therapy > 2 years was consistently associated with a lower risk. The protective effect attenuated with increasing age but remained significant in patients aged ≥ 80 years. In sensitivity analyses, metformin significantly reduced the risk of both OS and VF (with or without a prior OS) by 30-40%. Additional analyses showed a null association for other antidiabetic drugs, but significant interactions between metformin and insulin, sulfonylurea and pioglitazone, respectively, were noted. CONCLUSION: Metformin use is associated with a lower risk of OS/VF.
OBJECTIVES: To investigate the metformin effect on the risk of osteoporosis (OS) and/or vertebral fracture (VF). METHODS: We enrolled 14 611 pairs of metformin ever and never users matched on propensity score (PS) from Taiwan's National Health Insurance database. All patients had new-onset type 2 diabetes mellitus (T2DM) during 1999-2005 and were free from OS and/or any fracture at the start of follow-up on January 1, 2006. They were followed up until December 31, 2011 for the incidence of OS/VF. Cox regression incorporated with the inverse probability of treatment weighting using PS was used in the main analyses. RESULTS: New-onset OS/VF was diagnosed in 1757 never users (median follow-up 5.0 years) and 1143 ever users (median follow-up 5.3 years). The respective incidence rates were 2870.97 and 1713.20 per 100 000 person-years. Two-thirds of the incident cases had OS without VF and the other third had VF. In main analyses, the hazard ratio for ever vs never users was 0.592 (95% CI: 0.550-0.638). In either sex, a dose-response pattern was noted and metformin therapy > 2 years was consistently associated with a lower risk. The protective effect attenuated with increasing age but remained significant in patients aged ≥ 80 years. In sensitivity analyses, metformin significantly reduced the risk of both OS and VF (with or without a prior OS) by 30-40%. Additional analyses showed a null association for other antidiabetic drugs, but significant interactions between metformin and insulin, sulfonylurea and pioglitazone, respectively, were noted. CONCLUSION: Metformin use is associated with a lower risk of OS/VF.
Authors: V Van Hulten; Nicklas Rasmussen; J H M Driessen; A M Burden; A Kvist; J P van den Bergh Journal: Curr Osteoporos Rep Date: 2021-12-21 Impact factor: 5.096
Authors: Kathrin Kahnert; Rudolf A Jörres; Tanja Lucke; Franziska C Trudzinski; Pontus Mertsch; Christiane Bickert; Joachim H Ficker; Jürgen Behr; Robert Bals; Henrik Watz; Tobias Welte; Claus F Vogelmeier; Peter Alter Journal: Int J Chron Obstruct Pulmon Dis Date: 2021-11-24