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This prospective cohort study evaluated whether metformin use is associated with long-term IDD risk among 20,350 people with T2DM from the UK Biobank. Primary outcomes were incident IDD by ICD-10 codes, with hazard ratios from Cox models and sensitivity, subgroup, interaction, and prediction analyses for 5- and 13-year risk.",{"@graph":69,"@context":126},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/impact-of-metformin-on-intervertebral-disc-degeneration-in-patients-with-diabetes-a-prospective-cohort-study-from-the-uk-biobank/457720/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/impact-of-metformin-on-intervertebral-disc-degeneration-in-patients-with-diabetes-a-prospective-cohort-study-from-the-uk-biobank/457720.png","ImageObject",300,407,{"name":92,"@type":93},"jay","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-05","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":81},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118,122],{"name":109,"@type":110,"acceptedAnswer":111},"What was the study objective regarding metformin and IDD?","Question",{"text":112,"@type":113},"To evaluate the association between metformin use and long-term intervertebral disc degeneration (IDD) risk in patients with T2DM using UK Biobank data.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was incident IDD measured in this study?",{"text":117,"@type":113},"Incident IDD was identified using ICD-10 codes as the primary outcome in the prospective cohort.",{"name":119,"@type":110,"acceptedAnswer":120},"What were the main findings about metformin and IDD risk?",{"text":121,"@type":113},"Over a median follow-up of 13 years, metformin use was associated with a reduced IDD risk (HR 0.863, p=0.034), and results were robust in sensitivity analysis (HR 0.862, p=0.039).",{"name":123,"@type":110,"acceptedAnswer":124},"Were there any factors that modified the metformin effect?",{"text":125,"@type":113},"Yes. Significant interactions were observed with sleep time and hypertension status (P for interaction \u003C 0.05).","https://schema.org",{"og:url":83,"og:type":128,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":130,"canonical":83},"index,follow",{"doc_id":132,"site_id":62},457720,1790790189,{"code":4,"msg":5,"data":135},{"doc_id":132,"user_id":136,"nickname":92,"user_avatar":137,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":138,"file_id":139,"file_url":140,"file_type":141,"file_size":142,"view_count":81,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":143,"language":144,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":145,"faqs":146,"seo_title":147,"seo_description":67,"update_tm":148,"read_time":149},3985747858866,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","Chen et al. Diabetology & Metabolic Syndrome (2026) 18:10 [https://doi.org/10.1186/s13098-025-02050-7](https://doi.org/10.1186/s13098-025-02050-7)  \nDiabetology & Metabolic Syndrome  \nRESEARCH Open Access  \nImpact of metformin on intervertebral disc degeneration in patients with diabetes: a prospective cohort study from the UK biobank  \nJianan Chen 1†, Nianchun Liao 1†, Bo Gao 1†, Tongzhou Liang2,3, Wenjun Hu 1, Zaoqiang Zhang 1, Wangim Choi 1, Huihong Shi 1, Song Liu 1, Yanbo Chen 1, Youxi Lin 1, Zhihuai Deng 1, Xianjian Qiu 1*, Dongsheng Huang 1* and Wenjie Gao 1*  \nAbstract  \nObjective Intervertebral disc degeneration (IDD) is a major contributor to low back pain and disability. Emerging evidence suggests that type 2 diabetes mellitus (T2DM) accelerates IDD progression, while metformin, a first-line treatment forT2DM, may offer protective effects. This study aimed to evaluate the association between metforminuse and long-term IDD risk inT2DM patients using data from the UK Biobank.  \nMethods A prospective cohort of 20,350 individuals with T2DM was analyzed, including 11,158 metformin users and 9192 non-users. The primary outcome was incident IDD, identified via ICD-10 codes. Cox proportional hazards models estimated hazard ratios (HRs) for IDD, adjusting for demographic, behavioral, and clinical factors. A sensitivity analysis was performed by excluding patients with a follow-up period of less than 2 years to assess the stability of the results. Subgroup and interaction analyses explored effect modifiers. Predictive models using Cox regression were developed to estimate 5-and 13-year IDD risk, with model performance evaluated by area under the ROC curve (AUC) .  \nResults Over a median follow-up of 13 years, metformin use was significantly associated with a reduced risk of IDD [HR (95% CI): 0.863 (0 .753–0. 989), p = 0 . 034] . The results were robust in the sensitivity analysis[HR (95% CI): 0.862 (0 .749–0. 992), p = 0 . 039] . A significant interaction with sleep time and hypertension status were observed (P for interaction \u003C 0. 05) . Predictive model AUCs for 5-and 13-year IDD risk were 0.64 (95% CI: 0 .57–0. 70) and 0.69 (95% CI:  \n0.66–0. 73), respectively.  \n†Jianan Chen, Nianchun Liao and Bo Gao contributed equally to this work.  \n*Correspondence:  \nXianjian Qiu[qiuxj6@mail.sysu.edu.cn](qiuxj6@mail.sysu.edu.cn)[ ](qiuxj6@mail.sysu.edu.cn)Dongsheng Huang [hdongsh@mail.sysu.edu.cn](hdongsh@mail.sysu.edu.cn)[ ](hdongsh@mail.sysu.edu.cn)Wenjie Gao [gaowj7@mail.sysu.edu.cn](gaowj7@mail.sysu.edu.cn)  \nFull list of author information is available at the end of the article  \n© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creati](http://creati)[vecommons.org/l](vecommons.org/l)icenses/by-nc-nd/4.0/.  \nChen et al. Diabetology & Metabolic Syndrome (2026) 18:10 Page 2 of 13  \nConclusions These findings suggest that metformin may lower long-term IDD risk inT2DM patients, particularly those with hypertension, highlighting its potential role in IDD prevention and the need for further intervention","cbCaipXz48cs5bHc","https://ap.wps.com/l/cbCaipXz48cs5bHc","pdf",2012913,13,"English","# Abstract\n# Methods\n# Results\n# Conclusions\n# Keywords\n# Introduction","[{\"question\":\"What was the study objective regarding metformin and IDD?\",\"answer\":\"To evaluate the association between metformin use and long-term intervertebral disc degeneration (IDD) risk in patients with T2DM using UK Biobank data.\"},{\"question\":\"How was incident IDD measured in this study?\",\"answer\":\"Incident IDD was identified using ICD-10 codes as the primary outcome in the prospective cohort.\"},{\"question\":\"What were the main findings about metformin and IDD risk?\",\"answer\":\"Over a median follow-up of 13 years, metformin use was associated with a reduced IDD risk (HR 0.863, p=0.034), and results were robust in sensitivity analysis (HR 0.862, p=0.039).\"},{\"question\":\"Were there any factors that modified the metformin effect?\",\"answer\":\"Yes. Significant interactions were observed with sleep time and hypertension status (P for interaction \\u003c 0.05).\"}]","Impact of metformin on intervertebral disc degeneration in patients with diabetes - a prospective cohort study from the UK biobank | PDF",1790750230,33]