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Objective <p>To assess the association between metformin and osteoarthritis (OA) development and total joint arthroplasty (TJA) in a large prospective cohort.</p> Methods <p>From the UK Biobank, 348,070 people between the ages of 40 and 69 who did not have OA or TJA at baseline were included between 2006 and 2010 and investigated until January 2021. We used multivariable-adjusted Cox regression to test for an association between metformin and OA diagnosis (<i>n</i> = 51,111) and OA-related TJA (<i>n</i> = 21,754) in the cohort. Models 1 and 2 were adjusted for age, sex, and diabetes. Model 2 was also adjusted for additional variables, including the Townsend Deprivation Index, ethnicity, household income, body mass index, glycated hemoglobin, smoking and alcohol status, physical activity, hypertension, and medications including antihypertensive drug use, statin use, insulin treatment, aspirin use and glucosamine/chondroitin supplementation.</p> Results <p>At baseline, 14,128 (4.06%) of the 348,070 participants reported metformin prescriptions. The hazard ratio (HR) for OA, including knee OA (HR, 0.74; 95% confidence intervals (CI), 0.69 to 0.80) and hip OA (HR, 0.74; 95% CI 0.67 to 0.82), was 0.74 (95% CI, 0.70 to 0.77) for metformin users versus nonusers, but not hand OA (HR, 0.91; 95% CI 0.68 to 1.21). Metformin also reduced the risk of TJA (HR, 0.72; 95% CI 0.67 to 0.78). For OA, the association seemed to be stronger among nonobese, nondiabetic, and nonhypertensive participants (all <i>p</i> &lt; 0.05).</p> Conclusions <p>Metformin seems to reduce the risk of OA and TJA and may protect against OA in the general population.</p>

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Association of metformin with osteoarthritis progression and total joint arthroplasty: evidence from the UK Biobank, a large population-based cohort study

  • 期刊论文

  • 发表日期：

    2026年6月29日

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  • Yunze Kang,
  • Yiling Liu,
  • Lingli Long,
  • Weishen Chen,
  • Zhiqi Zhang,
  • Minghui Gu,
  • Chao Wang,
  • Chengxin Li,
  • Shiyong Zhang,
  • Baiqi Pan,
  • Xiaoyu Wu,
  • Ali Mobasheri,
  • Ziji Zhang,
  • Puyi Sheng,
  • Linli Zheng

摘要

Objective

To assess the association between metformin and osteoarthritis (OA) development and total joint arthroplasty (TJA) in a large prospective cohort.

Methods

From the UK Biobank, 348,070 people between the ages of 40 and 69 who did not have OA or TJA at baseline were included between 2006 and 2010 and investigated until January 2021. We used multivariable-adjusted Cox regression to test for an association between metformin and OA diagnosis (n = 51,111) and OA-related TJA (n = 21,754) in the cohort. Models 1 and 2 were adjusted for age, sex, and diabetes. Model 2 was also adjusted for additional variables, including the Townsend Deprivation Index, ethnicity, household income, body mass index, glycated hemoglobin, smoking and alcohol status, physical activity, hypertension, and medications including antihypertensive drug use, statin use, insulin treatment, aspirin use and glucosamine/chondroitin supplementation.

Results

At baseline, 14,128 (4.06%) of the 348,070 participants reported metformin prescriptions. The hazard ratio (HR) for OA, including knee OA (HR, 0.74; 95% confidence intervals (CI), 0.69 to 0.80) and hip OA (HR, 0.74; 95% CI 0.67 to 0.82), was 0.74 (95% CI, 0.70 to 0.77) for metformin users versus nonusers, but not hand OA (HR, 0.91; 95% CI 0.68 to 1.21). Metformin also reduced the risk of TJA (HR, 0.72; 95% CI 0.67 to 0.78). For OA, the association seemed to be stronger among nonobese, nondiabetic, and nonhypertensive participants (all p < 0.05).

Conclusions

Metformin seems to reduce the risk of OA and TJA and may protect against OA in the general population.