ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2024
Metformin treatment reduces the incidence of osteoporosis: a two-sample Mendelian randomized study.
Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- Mendelian randomization studies of risk and protective factors for osteoporosis: a systematic review and meta-analysis.Frontiers in endocrinology · 2024Pooled it
- A Letter Matters: ADRB2 rs1042713 c.46A Modulates Anti-osteogenic Effect of Epinephrine in Human Mesenchymal Stem Cells.Stem cell reviews and reports · 2026Article
- Deep learning-based CT-derived vertebral bone mineral density and metformin therapy: a longitudinal study in the Multi-Ethnic Study of Atherosclerosis.Skeletal radiology · 2026Article
- Metformin beyond Glycemic Control: New Mechanistic Insights and Expanding Therapeutic Horizons.Diabetes & metabolism journal · 2026Review
- Managing Bone Fragility in Older Adults with Diabetes: Pathophysiology, Assessment, and Therapeutic Considerations.Drugs & aging · 2026Review
- Targeting innate immunity to modulate bone metabolism: a novel strategy for osteoporosis treatment.Frontiers in aging · 2026Review
- Metformin attenuates diabetic osteoporosis via the miR-21 mediated Mef2c/Sost pathway.Frontiers in endocrinology · 2026Article
- Interaction between diabetes and osteoporosis: imbalance between inflammation and bone remodeling.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Review
- From Diabetes to Degenerative Diseases: The Multifaceted Action of Metformin.International journal of molecular sciences · 2025Review
- Prolonged administration of letrozole induces polycystic ovary syndrome leading to osteoporosis in rats: model development and validation studies.Naunyn-Schmiedeberg's archives of pharmacology · 2025Article
- The association between chronic liver disease and osteoporosis in East Asian populations: a bidirectional Mendelian randomization study.Aging clinical and experimental research · 2025Article
- Vitamin D Status Determines Metformin Action on Gonadotropin Levels in Postmenopausal Women with Subclinical Hyperthyroidism.Pharmaceutics · 2025Article
- The role of ferroptosis in osteoporosis: from pathogenic mechanisms to natural product-driven therapeutic innovations.Frontiers in medicine · 2025Review
- The status and trends of type 2 diabetic osteoporosis research: a global bibliometric and visualization analysis over the past 20 years.Frontiers in clinical diabetes and healthcare · 2025Article
- Metformin improves HPRT1-targeted purine metabolism and repairs NR4A1-mediated autophagic flux by modulating FoxO1 nucleocytoplasmic shuttling to treat postmenopausal osteoporosis.Cell death & disease · 2024Article
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
It remains unclear whether the association between metformin and osteoporosis (OP) risk is causal. This two-sample Mendelian randomization (MR) study suggests a causal relationship between metformin treatment and a decrease in OP and fracture incidence, as well as an increase in bone mineral density (BMD) in the lumbar spine, femoral neck, and heel. Nonetheless, no significant causal effect is observed on forearm BMD. PURPOSE: We utilize a MR approach to investigate the association between metformin treatment and the risk of OP.
methodsMetformin treatment was selected as exposures. Outcomes included OP; BMD at the forearm (FA), femoral neck (FN), and lumbar spine (LS); estimated heel bone mineral density (eBMD); and fracture. Summary statistics for exposures and outcomes were obtained from corresponding genome-wide association studies. Inverse variance-weighted (IVW) analysis was mainly applied; the weighted median (WM), penalized weighted median (PWM), maximum likelihood (ML), and MR-Egger regression (MR-Egger) method were also used to obtain robust estimates. A series of sensitivity analyses including Cochran's Q test, MR-Egger regression, leave-one-out analysis, and Mendelian randomization pleiotropy residual sum and outlier (MR-PRESSO) were used to detect pleiotropy or heterogeneity.
resultsIn the main analysis, IVW estimates demonstrated that metformin treatment had a definite causal effect on the risk of OP (odds ratio (OR): 0.859, 95% CI: 0.774-0.953, P = 0.004), LS-BMD (OR: 1.063, 95% CI: 1.023-1.105, P = 0.002), FN-BMD (OR: 1.034, 95% CI: 1.000-1.069, P = 0.049), eBMD (OR: 1.035, 95% CI: 1.023-1.047, P ≤ 0.001), and fracture(OR: 0.958, 95% CI: 0.928-0.989, P = 0.008). However, it did not have an effect on FA-BMD(OR: 1.050, 95% CI: 0.969-1.138, P = 0.237).
conclusionsThis study indicated that metformin treatment is significantly associated with a reduction in the risk of OP, fracture and higher LS-BMD, FN-BMD, and eBMD. However, there was no significant association with FA-BMD.
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