Case Control Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 26, 2020; 8(18): 4010-4016
Published online Sep 26, 2020. doi: 10.12998/wjcc.v8.i18.4010
Effects of different doses of metformin on bone mineral density and bone metabolism in elderly male patients with type 2 diabetes mellitus
Lin-Xia Wang, Guang-Ya Wang, Na Su, Jie Ma, Yu-Kun Li
Lin-Xia Wang, Yu-Kun Li, Department of Endocrinology, The Third Hospital of Hebei Medical University, Shijiazhuang 050051, Hebei Province, China
Lin-Xia Wang, Guang-Ya Wang, Na Su, Jie Ma, Second Department of Endocrinology, Cangzhou Central Hospital, Cangzhou 061001, Hebei Province, China
Yu-Kun Li, Key Orthopaedic Biomechanics Laboratory of Hebei Province, Shijiazhuang 050051, Hebei Province, China
Author contributions: Wang LX, Li YK, Su N, Ma J and Wang GY collected the data and wrote and edited the manuscript; all the authors approved the publication of the manuscript.
Institutional review board statement: The study was approved by Ethics Committee of Cangzhou Central Hospital.
Informed consent statement: All patients gave informed consent.
Conflict-of-interest statement: The authors declare that there is no conflict of interest.
Data sharing statement: No additional data available.
STROBE statement: The manuscript has been prepared and revised according to the STROBE statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Yu-Kun Li, PhD, Professor, Department of Endocrinology, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang 050051, Hebei Province, China. lykun1962@163.com
Received: June 5, 2020
Peer-review started: June 5, 2020
First decision: July 25, 2020
Revised: August 12, 2020
Accepted: August 22, 2020
Article in press: August 22, 2020
Published online: September 26, 2020
Processing time: 108 Days and 16.7 Hours
ARTICLE HIGHLIGHTS
Research background

Patients with diabetes mellitus may develop skeletal complications including osteopenia, osteoporosis and even fracture. Although metformin is used as an antidiabetic rather than an antiosteoporotic medicine, it is essential to examine the effects of metformin on bone metabolism because it is a widely used medication to treat diabetes in this population.

Research motivation

By comparing different doses of metformin on bone metabolism and bone mineral density (BMD) in patients with type 2 diabetes, the optimal dose of metformin will be estimated to achieve the benefits of bone protection beyond glycemic control.

Research objectives

The aim of this study is to compare the effects of a high dose vs low dose of metformin on BMD and bone metabolism in patients with type 2 diabetes mellitus.

Research methods

One hundred and twenty patients with type 2 diabetes were enrolled in the study. They were assigned to a high dose metformin group (2 g daily) and a low dose metformin group (1 g daily) with 60 patients in each group for 12 wk. Changes in BMD and bone metabolism as well as the efficacy of the treatment were compared between the two groups before and after treatment.

Research results

The results showed that there was no significant difference in the treatment efficacy between the two treatment groups. After the treatment, levels of BMD and bone metabolic markers were improved. To be specific, levels of BMD and 25-hydroxyvitamin D were higher in the high dose metformin group than in the low dose metformin group. However, levels of N-terminal midfragment and β-isomerized C-terminal telopeptides were lower in the high dose metformin group than in the low dose metformin group.

Research conclusions

A high dosage of metformin can help to improve osteoporosis as well as control blood glucose in elderly male patients with type 2 diabetes mellitus.

Research perspectives

The effects of metformin on BMD and bone metabolism should be further evaluated in long-term observational studies with large sample sizes.