Metformin use is associated with a lower risk of osteoporosis in adult women independent of type 2 diabetes mellitus and obesity. REDLINC IX study

Abstract

Metformin may decrease cell senescence, including bone; hence we aimed at evaluating the association between metformin use and osteoporosis. This was a cross-sectional study carried out in 1259 Latin American adult women aged 40 or more who were not on anti-osteoporotic drugs, were on metformin and had a bone densitometry performed. Of the whole sample, 40.3% reported being on metformin (at least 1 year), 30.2% had type 2 diabetes mellitus and 22.6% had osteoporosis. Median (interquartile range) body mass index (BMI) for the whole cohort was 27.7 (4.6) kg/m² and 30.2% had type 2 diabetes mellitus. Current use of hormone therapy, calcium, and vitamin D corresponded respectively to 10.7%, 47.7%, and 43.1% of all surveyed women. A logistic regression model was used to analyze the association of osteoporosis with various covariates incorporated into the model such as age (OR: 1.07, 95% CI: 1.05–1.09), BMI (OR: 0.92, 95% CI: 0.89–0.96) and metformin use (OR: 0.44, 95% CI: 0.32–0.59). Metformin use, regardless of the presence of type 2 diabetes or obesity, was associated with a lower risk of osteoporosis in adult women. We propose that one explanation for this observation could be the effect of the drug over cellular senescence.

摘要：

二甲双胍可减少细胞衰老, 包括骨骼；因此, 我们旨在评估应用二甲双胍与骨质疏松症之间的关系。这是一项横断面研究, 研究人群是年龄在40岁或40岁以上的1259名拉丁美洲成年女性, 她们均服用二甲双胍, 并没有服用过抗骨质疏松药物, 都进行了骨密度测定。在全部样本中, 40.3%的患者服用过二甲双胍（至少一年）, 30.2%的患者患有2型糖尿病, 22.6%的患者患有骨质疏松症。整个队列的体重指数（BMI）中位数（四分位间距）为27.7（4.6）kg/m2, 30.2%患有2型糖尿病。目前激素治疗、钙和维生素D的使用率分别为10.7%、47.7%和43.1%。采用logistic回归模型分析骨质疏松症与年龄（OR:1.07, 95%CI:1.05-1.09）、体重指数（OR:0.92, 95%CI:0.89-0.96）和应用二甲双胍（OR:0.44, 95%CI:0.32-0.59）等各种协变量的关系。无论患者是否存在2型糖尿病或肥胖, 应用二甲双胍与成年女性骨质疏松低风险相关。我们认为原因可能是二甲双胍可以减少细胞衰老。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• Metformin
• osteoporosis
• senescence
• aging

Acknowledgments

The authors would like to thank women who participated in this initiative.

Disclosure statement

The authors report no potential conflicts of interest.

Additional information

Funding

This research was partially supported by the Sistema de Investigación y Desarrollo and the Vice-Rectorado de Investigación & Postgrado of the Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador, through grant No. SIU-318–853-2014 (The Omega II, Women’s Health Project 2014) provided to Peter Chedraui.