PMID- 36926032 OWN - NLM STAT- MEDLINE DCOM- 20230320 LR - 20230324 IS - 1664-2392 (Print) IS - 1664-2392 (Electronic) IS - 1664-2392 (Linking) VI - 14 DP - 2023 TI - Metformin treatment and risk of diabetic peripheral neuropathy in patients with type 2 diabetes mellitus in Beijing, China. PG - 1082720 LID - 10.3389/fendo.2023.1082720 [doi] LID - 1082720 AB - BACKGROUND: Metformin treatment is associated with vitamin B12 deficiency, which is a risk factor for neuropathy. However, few studies have examined the relationship between metformin treatment and diabetic peripheral neuropathy (DPN), and the available findings are contradictory. We aimed to assess whether metformin treatment is associated with DPN in patients with type 2 diabetes mellitus (T2DM) in Beijing, China. METHODS: All patients with newly diagnosed T2DM between January 2010 and September 2012 in the Medical Claim Data for Employees database were included. Metformin treatment was defined as any record of metformin prescription. The average daily dose of metformin during follow-up was calculated. DPN was defined as DPN admissions occurring after a diagnosis of T2DM in the database. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards models. RESULTS: Among 49,705 T2DM patients, 1,933 DPN events were recorded during a median follow-up of 6.36 years. The crude incidence rates were 7.12 and 3.91 per 1000 person-years for patients treated with metformin (N=37,052) versus those not treated (N=12,653). Patients treated with metformin had an 84% increased risk of DPN compared with patients not using metformin (HR, 1.84; 95% CI, 1.62, 2.10). The daily dose was positively associated with DPN risk (HR, 1.48; 95% CI, 1.46, 1.51; P for trend <0.001). The risk of DPN was 1.53-fold (1.30, 1.81) and 4.31-fold (3.76, 4.94) higher in patients with daily doses of 1.0-2.0 g and >2.0 g, respectively, than in patients who did not receive treatment. Patients aged less than 60 years had a higher risk of DPN (P<0.05 for interaction test). Among patients taking vitamin B12 at baseline, there was no increased risk of DPN in the metformin group (1.92: 0.79, 4.69). CONCLUSIONS: In Chinese patients with T2DM, metformin treatment was associated with an increased risk of DPN admission and this risk responds positively to the daily dose of metformin. In particular, metformin use was a major risk factor for DPN in younger patients. Concomitant use of vitamin B12 may avoid the increased risk of DPN associated with metformin use. CI - Copyright (c) 2023 Yang, Yu, Wu, Chen, Wang, Wang, Qin, Wu, Wu and Hu. FAU - Yang, Ruotong AU - Yang R AD - Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China. FAU - Yu, Huan AU - Yu H AD - Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China. FAU - Wu, Junhui AU - Wu J AD - Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China. AD - School of Nursing, Peking University, China, Beijing, China. FAU - Chen, Hongbo AU - Chen H AD - Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China. AD - School of Nursing, Peking University, China, Beijing, China. FAU - Wang, Mengying AU - Wang M AD - Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China. FAU - Wang, Siyue AU - Wang S AD - Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China. FAU - Qin, Xueying AU - Qin X AD - Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China. FAU - Wu, Tao AU - Wu T AD - Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China. FAU - Wu, Yiqun AU - Wu Y AD - Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China. FAU - Hu, Yonghua AU - Hu Y AD - Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China. AD - Medical Informatics Center, Peking University, Beijing, China. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20230228 PL - Switzerland TA - Front Endocrinol (Lausanne) JT - Frontiers in endocrinology JID - 101555782 RN - 9100L32L2N (Metformin) RN - P6YC3EG204 (Vitamin B 12) SB - IM MH - Humans MH - Middle Aged MH - *Diabetes Mellitus, Type 2/complications/drug therapy/epidemiology MH - *Metformin/adverse effects MH - *Diabetic Neuropathies/drug therapy/epidemiology/etiology MH - Beijing/epidemiology MH - Vitamin B 12/therapeutic use PMC - PMC10011647 OTO - NOTNLM OT - Beijing Medical Claim Data for Employees database OT - cohort study OT - diabetic peripheral neuropathy OT - metformin OT - type 2 diabetes COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2023/03/18 06:00 MHDA- 2023/03/21 06:00 PMCR- 2023/01/01 CRDT- 2023/03/17 02:41 PHST- 2022/10/28 00:00 [received] PHST- 2023/02/10 00:00 [accepted] PHST- 2023/03/17 02:41 [entrez] PHST- 2023/03/18 06:00 [pubmed] PHST- 2023/03/21 06:00 [medline] PHST- 2023/01/01 00:00 [pmc-release] AID - 10.3389/fendo.2023.1082720 [doi] PST - epublish SO - Front Endocrinol (Lausanne). 2023 Feb 28;14:1082720. doi: 10.3389/fendo.2023.1082720. eCollection 2023.