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
Abstract
BACKGROUND

Diabetes is a chronic disease, which may cause various complications. Patients with diabetes are at high risk of bone and joint disorders, such as osteoporosis and bone fractures. In addition, it became widely accepted that diabetes has an important impact on bone metabolism. Metformin is a commonly used and effective first-line treatment for type 2 diabetes. Some glucose-lowering agents have been found to have an effect on bone metabolism. The present study explored if different doses of metformin have an effect on bone mineral density (BMD) and bone metabolism in type 2 diabetes.

AIM

To investigate the effects of different doses of metformin on BMD and bone metabolism in elderly male patients with type 2 diabetes mellitus.

METHODS

A total of 120 elderly male outpatients with type 2 diabetes mellitus who were admitted to our hospital were included in the study from July 2018 to June 2019. They were randomly assigned to an experimental group and a control group with 60 patients in each group. Patients in the experimental group were given high dose metformin four times a day 0.5 g each time for 12 wk. Patients in the control group were given low dose metformin orally twice a day 0.5 g each time for 12 wk. The changes in bone mineral density and bone metabolism before and after treatment and the efficacy rate of the treatment were compared between the two groups.

RESULTS

There was no significant difference in the efficacy rate between the two groups (P > 0.05). Before the treatment, there was no significant difference in BMD and bone metabolism between the two groups (P > 0.05). However, after the treatment, BMD and bone metabolism were improved in the two groups. Moreover, BMD and 25-hydroxyvitamin D were significantly higher in the experimental group than in the control group, and N-terminal/midregion and β-isomerized C-terminal telopeptides were significantly lower in the experimental group than in the control group (all P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P > 0.05).

CONCLUSION

Both high and low dose metformin can effectively control the blood glucose levels in elderly male patients with type 2 diabetes mellitus. However, the benefits of high dose metformin in improving BMD and bone metabolism level was more obvious in patients with type 2 diabetes mellitus.

Keywords: Dosages, Metformin, Type 2 diabetes mellitus, Elderly male patients, Bone mineral density, Bone metabolism

Core Tip: In the last two decades, metformin has been a widely used medicine in the treatment of diabetes. It has been proven to have additional benefits in anticancer and antiaging beyond glycemic control. To answer whether it has a positive effect on bone mineral density and bone metabolism, the present study compared the outcomes of bone mineral density and bone metabolism between different doses of metformin in patients with type 2 diabetes. The results supported that a comparatively higher dose of metformin helped to improve bone mineral density and bone metabolism levels in patients with type 2 diabetes.