Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Bone. 2020 Jun;135:115325. doi: 10.1016/j.bone.2020.115325. Epub 2020 Mar 19.
This study aimed to investigate the potential association of exposure to metformin therapy with the risk of hip fracture in adult patients with type II diabetes. We included patients with diabetes who were registered in the 2010 sample cohort database of the National Health Insurance Service in South Korea.
The patients who had been prescribed continuous oral metformin therapy for a 1-year period in 2010 were defined as the metformin group, while those who were not prescribed metformin during the same period were classified as the control group. The primary endpoint of this study was the development of hip fracture between January 2011 and December 2015.
A total of 64,878 patients (31,300 patients in the metformin group and 32,439 patients in the control group) were included in this study. Among those, 1655 patients (2.6%) had experienced a hip fracture. After a propensity score matching, a total of 37,378 patients (18,689 patients in each group) were included in the analysis. Using a time-dependent Cox regression analysis on the propensity score-matched cohort, the exposure to metformin was not significantly associated with the development of hip fracture compared to the control group (hazard ratio: 1.00, 95% confidence interval: 0.86 to 1.16; P = 0.985). Similar results were observed using sensitivity analysis of a multivariable time-dependent Cox regression model of the entire cohort (hazard ratio: 0.78, 95% confidence interval: 0.36 to 1.69; P = 0.525).
This population-based cohort study in South Korea showed that there was no significant association between the exposure to metformin therapy and hip fracture in patients with type II diabetes mellitus.
本研究旨在探讨二甲双胍治疗暴露与成年 2 型糖尿病患者髋部骨折风险之间的潜在关联。我们纳入了在韩国国民健康保险服务 2010 年样本队列数据库中登记的糖尿病患者。
2010 年接受连续口服二甲双胍治疗 1 年的患者被定义为二甲双胍组，同期未服用二甲双胍的患者被归类为对照组。本研究的主要终点是 2011 年 1 月至 2015 年 12 月期间发生髋部骨折。
共有 64878 名患者（二甲双胍组 31300 名，对照组 32439 名）纳入本研究。其中 1655 名（2.6%）患者发生髋部骨折。经过倾向评分匹配后，共有 37378 名患者（每组 18689 名）纳入分析。在倾向评分匹配队列中使用时间依赖性 Cox 回归分析，与对照组相比，二甲双胍暴露与髋部骨折的发生无显著相关性（风险比：1.00，95%置信区间：0.86 至 1.16；P=0.985）。在整个队列的多变量时间依赖性 Cox 回归模型的敏感性分析中也观察到了类似的结果（风险比：0.78，95%置信区间：0.36 至 1.69；P=0.525）。
这项基于人群的韩国队列研究表明，在 2 型糖尿病患者中，二甲双胍治疗暴露与髋部骨折之间无显著关联。
