Evidence mapPaperPMID 40165152Full record

ArticleBMC musculoskeletal disorders2025

Metformin use and risk of total joint replacement in patients with diabetes: a longitudinal cohort study of Alberta's Tomorrow Project.

Ming Ye, Jennifer E Vena, Grace Shen-Tu, Jeffrey A Johnson, Dean T Eurich

Abstract read
In one paragraph

Article in BMC musculoskeletal disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Ming YeSchool of Public Health, University of Alberta, Edmonton, AB, Canada.
Jennifer E VenaAlberta's Tomorrow Project, CancerCare Alberta, Alberta Health Services, Calgary, AB, Canada.
Grace Shen-TuAlberta's Tomorrow Project, CancerCare Alberta, Alberta Health Services, Calgary, AB, Canada.
Jeffrey A JohnsonSchool of Public Health, University of Alberta, Edmonton, AB, Canada.
Dean T EurichSchool of Public Health, University of Alberta, Edmonton, AB, Canada. deurich@ualberta.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo characterize the association between metformin use and risk of total joint replacement in patients with diabetes using data from Alberta's Tomorrow Project (ATP), a population-based cohort study of chronic diseases in Alberta, Canada.

methodsThe ATP participants with incidence of diabetes after enrollment were included and followed up to March 31, 2021. Metformin use, including daily doses, was measured by a time-varying approach during the follow-up. A multivariable Cox regression model was used to characterize the association between metformin use and risk of total joint replacement, after controlling for time-related variation in drug use, clinical status, BMI, lifestyles and concurrent medications.

resultsAmong 3,001 incident cases of diabetes (52% females, age at diagnosis 61.3 ± 9.5 years, average follow-up of 7.3 ± 4.7 years), the rate of total joint replacement was 7.57 per 1,000 person-year (PY) for metformin users and 9.31 per 1,000 PY for non-metformin users, with rate ratio = 0.81 (95% CI = 0.59-1.11, p-value = 0.09). In multivariable Cox regression analysis, metformin use was not significantly associated with risk of total joint replacement, with hazard ratio of 0.74 (95% CI = 0.52-1.03, p-value = 0.07) for patients with metformin medication, HR = 0.75 (95% CI = 0.46-1.22) for 0-1.0 g/day metformin use, and HR = 0.73 (95% CI = 0.49-1.08) for 1.0 + g/day use ('no metformin use' as the reference group).

conclusionsAlthough our findings are not statistically significant, our study suggests clinically a potential benefit of metformin use in reducing risk of total joint replacement in patients with diabetes.

Indexed as

Arthroplasty, ReplacementDiabetes MellitusDiabetes Mellitus, Type 2Hypoglycemic AgentsMetforminAgedAlbertaCohort StudiesFemaleFollow-Up StudiesHumansIncidenceLongitudinal StudiesMaleMiddle AgedRisk FactorsHypoglycemic AgentsMetforminCohort studyDiabetesMetforminTime-varyingTotal joint replacement

Identifiers

PMID40165152
PMCPMC11956490

What Socratic holds

Texttitle and abstract
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.