Department of Pharmacy, Shanghai Fourth People's Hospital Affiliated to Tongji University, Shanghai, Shanghai, China.
Obstetrics and Gynecology Hospital of Fudan University, Shanghai, Shanghai, China
BMJ Open. 2023 Jun 23;13(6):e072904. doi: 10.1136/bmjopen-2023-072904.
Metformin is associated with osteoblastogenesis and osteoclastogenesis. This study aims to investigate the impacts of metformin therapy on bone mineral density (BMD) and bone turnover markers.
Systematic review and meta-analysis of randomised controlled trials.
Searches were carried out in PubMed, EMBASE, Web of science, Cochrane library, ClinicalTrials.gov from database inception to 26 September 2022. Two review authors assessed trial eligibility in accordance with established inclusion criteria. The risk of bias was assessed using the Cochrane Risk of Bias tool (RoB V.2.0). Data analysis was conducted with Stata Statistical Software V.16.0 and Review Manager Software V.5.3.
A total of 15 studies with 3394 participants were identified for the present meta-analysis. Our pooled results indicated that metformin had no statistically significant effects on BMD at lumbar spine (SMD=-0.05, 95% CI=0.19 to 0.09, p=0.47, participants=810; studies=7), at femoral (MD=-0.01 g/cm, 95% CI=-0.04 to 0.01 g/cm, p=0.25, participants=601; studies=3) and at hip (MD=0.01 g/cm, 95% CI=0.02 to 0.03 g/cm, p=0.56, participants=634; studies=4). Metformin did not lead to significant change in osteocalcin, osteoprotegerin and bone alkaline phosphatase. Metformin induced decreases in N-terminal propeptide of type I procollagen (MD=-6.09 µg/L, 95% CI=9.38 to -2.81 µg/L, p=0.0003, participants=2316; studies=7) and C-terminal telopeptide of type I collagen (MD=-55.80 ng/L, 95% CI=97.33 to -14.26 ng/L, p=0.008, participants=2325; studies=7).
This meta-analysis indicated that metformin had no significant effect on BMD. Metformin decreased some bone turnover markers as N-terminal propeptide of type I procollagen and C-terminal telopeptide of type I collagen. But the outcomes should be interpreted with caution due to several limitations.
二甲双胍与成骨细胞和破骨细胞的形成有关。本研究旨在探讨二甲双胍治疗对骨密度（BMD）和骨转换标志物的影响。
随机对照试验的系统评价和荟萃分析。
从数据库建立到 2022 年 9 月 26 日，在 PubMed、EMBASE、Web of Science、Cochrane 图书馆和 ClinicalTrials.gov 中进行了检索。两名综述作者根据既定纳入标准评估了试验的合格性。使用 Cochrane 偏倚风险工具（RoB V.2.0）评估偏倚风险。使用 Stata 统计软件 V.16.0 和 Review Manager 软件 V.5.3 进行数据分析。
共确定了 15 项研究，共有 3394 名参与者纳入本荟萃分析。我们的汇总结果表明，二甲双胍对腰椎（SMD=-0.05，95%CI=0.19 至 0.09，p=0.47，参与者=810；研究=7）、股骨（MD=-0.01 g/cm，95%CI=-0.04 至 0.01 g/cm，p=0.25，参与者=601；研究=3）和髋部（MD=0.01 g/cm，95%CI=0.02 至 0.03 g/cm，p=0.56，参与者=634；研究=4）的 BMD 没有统计学上的显著影响。二甲双胍没有导致骨钙素、骨保护素和骨碱性磷酸酶发生显著变化。二甲双胍诱导的 I 型前胶原 N 端肽（MD=-6.09 µg/L，95%CI=9.38 至-2.81 µg/L，p=0.0003，参与者=2316；研究=7）和 I 型胶原 C 端肽（MD=-55.80 ng/L，95%CI=97.33 至-14.26 ng/L，p=0.008，参与者=2325；研究=7）减少。
本荟萃分析表明，二甲双胍对 BMD 没有显著影响。二甲双胍降低了一些骨转换标志物，如 I 型前胶原 N 端肽和 I 型胶原 C 端肽。但由于存在多种局限性，结果应谨慎解释。
