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. 2020 Sep 2;9(9):2839.
doi: 10.3390/jcm9092839.

Metformin Attenuates Osteoporosis in Diabetic Patients with Carcinoma in Situ: A Nationwide, Retrospective, Matched-Cohort Study in Taiwan

Chieh-Hua Lu  1   2 , Chi-Hsiang Chung  3   4 , Feng-Chih Kuo  1 , Kuan-Chan Chen  1 , Chia-Hao Chang  1 , Chih-Chun Kuo  1 , Chien-Hsing Lee  1 , Sheng-Chiang Su  1 , Jhih-Syuan Liu  1 , Fu-Huang Lin  3 , Chang-Huei Tsao  5   6 , Po-Shiuan Hsieh  2   7   8 , Yi-Jen Hung  1 , Chang-Hsun Hsieh  1 , Wu-Chien Chien  2   3
Affiliations

Metformin Attenuates Osteoporosis in Diabetic Patients with Carcinoma in Situ: A Nationwide, Retrospective, Matched-Cohort Study in Taiwan

Chieh-Hua Lu et al. J Clin Med. .

Abstract

Patients with diabetes are at increased risk of cancer development and osteoporosis. Metformin is an effective agent for diabetes management. Epidemiological studies have identified an association between metformin use and cancer prevention. This article outlines the potential for metformin to attenuate the rate of osteoporosis in diabetic patients with carcinoma in situ (CIS). From the National Health Insurance Research Database of Taiwan, 7827 patients with diabetes with CIS who were receiving metformin therapy were selected, along with 23,481 patients as 1:3 sex-, age- and index year-matched controls, who were not receiving metformin therapy. A Cox proportional hazard analysis was used to compare the rate of osteoporosis during an average of 15-year follow-up. Of the subjects who were enrolled, 801 (2.56%) had osteoporosis, including 168 from the metformin group (2.15%) and 633 from the without metformin group (2.70%). The metformin group presented a lower rate of osteoporosis at the end of follow-up (p = 0.009). The Cox proportional hazard regression analysis revealed a lower rate of osteoporosis for the metformin group (adjusted hazard ratio of 0.820; 95% confidence interval = 0.691-0.972, p = 0.022). Diabetic patients with CIS under metformin therapy presented lower osteoporosis rate than those who were not receiving metformin therapy.

Keywords: National Health Insurance Research Database; carcinoma in situ; diabetes; metformin; osteoporosis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of study patient selection from the National Health Insurance Research Database in Taiwan. DM—Diabetes mellitus: ICD-9-CM 250; Carcinoma in situ: ICD-9-CM 230–234; Osteoporosis: ICD-9-CM 733.0; Metformin: ≥90 days.
Figure 2
Figure 2
Kaplan-Meier analysis of cumulative risk of osteoporosis among patients with diabetes mellitus with carcinoma in situ aged 18 and over, stratified by metformin use and analyzed using a log-rank test.
See this image and copyright information in PMC

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