Barnett Lauren A, Jordan Kelvin P, Edwards John J, van der Windt Danielle A
1NIHR Research Methods Fellow,Arthritis Research UK Primary Care Centre,Research Institute for Primary Care & Health Sciences,Keele University,Staffordshire,UK.
2Professor of Biostatistics,Arthritis Research UK Primary Care Centre,Research Institute for Primary Care & Health Sciences,Keele University,Staffordshire,UK.
Prim Health Care Res Dev. 2017 Nov;18(6):623-628. doi: 10.1017/S1463423617000287. Epub 2017 May 25.
Obesity is a major risk factor for osteoarthritis (OA) whilst there is some evidence that diabetes also increases risk. Metformin is a common oral treatment for those with diabetes.
The aim is to investigate whether metformin reduces the risk of OA.
This was a cohort study set within the Consultations in Primary Care Archive, with 3217 patients with type 2 diabetes. Patients at 13 general practices with recorded type 2 diabetes in the baseline period (2002-2003) and no prior record of OA were identified. Exposure was a prescription for metformin. Outcome was an OA record during follow up. Cox proportional hazard models with Gamma frailty term were fitted: adjusted for age, gender, deprivation, and comorbidity.
There was no association between prescribed metformin treatment at baseline and OA (adjusted HR: 1.02, 95% CI: 0.91, 1.15). A similar non- significant association was found when allowing exposure status of prescription of metformin to vary over time.
肥胖是骨关节炎（OA）的主要风险因素，同时有证据表明糖尿病也会增加患病风险。二甲双胍是糖尿病患者常用的口服治疗药物。
旨在研究二甲双胍是否能降低患骨关节炎的风险。
这是一项基于初级保健档案咨询的队列研究，纳入了3217例2型糖尿病患者。在13家全科诊所中，确定了在基线期（2002 - 2003年）有2型糖尿病记录且无骨关节炎既往记录的患者。暴露因素为二甲双胍处方。结局为随访期间的骨关节炎记录。采用带有伽马脆弱项的Cox比例风险模型进行拟合：对年龄、性别、贫困程度和合并症进行了调整。
基线时开具的二甲双胍治疗与骨关节炎之间无关联（调整后风险比：1.02，95%置信区间：0.91，1.15）。当允许二甲双胍处方的暴露状态随时间变化时，也发现了类似的无显著关联。
