TY  - JOUR
AU  - Chen, Li-Ju
AU  - Herder, Christian
AU  - Xie, Ruijie
AU  - Brenner, Hermann
AU  - Schöttker, Ben
TI  - Comparison of the metabolic profiles and their cardiovascular event risks of metformin users versus insulin users. A cohort study of people with type 2 diabetes from the UK Biobank.
JO  - Diabetes research and clinical practice
VL  - 222
SN  - 0168-8227
CY  - Amsterdam [u.a.]
PB  - Elsevier Science
M1  - DKFZ-2025-00613
SP  - 112108
PY  - 2025
N1  - #EA:C070#LA:C070#
AB  - The aims of this study were to compare the metabolic profiles of type 2 diabetes mellitus patients with metformin and insulin monotherapy, to assess the associations of metabolites with major adverse cardiovascular events (MACE) distinctly for metformin-only and insulin-only users, and to test for effect modification by the glucose-lowering treatment.We included 3,058 metformin-only and 558 insulin-only users from the UK Biobank. Mean concentrations of 249 metabolites of metformin and insulin users were compared with Cohen's d, their associations with MACE were assessed with Cox regression and interaction terms were tested.Mean VLDL size, HDL size, and concentrations of large and very large HDL molecules differed between insulin-only and metformin-only users. Overall, 75 metabolomic biomarkers were significantly associated with MACE in insulin-only users and 57 in metformin-only users. Significant interaction terms were observed between treatment group and albumin (protective in metformin users only) and 86 lipids/fatty acids, which were all statistically significantly associated with MACE among insulin users only.Metformin and insulin users have different metabolic profiles and a consistent pattern emerged that the metabolic profile of metformin users is favorable compared to the one of insulin users due to a lower associated MACE risk.
KW  - Diabetes mellitus (Other)
KW  - Insulin (Other)
KW  - Lipids (Other)
KW  - Major adverse cardiovascular event (Other)
KW  - Metabolomics (Other)
KW  - Metformin (Other)
LB  - PUB:(DE-HGF)16
C6  - pmid:40122179
DO  - DOI:10.1016/j.diabres.2025.112108
UR  - https://inrepo02.dkfz.de/record/300115
ER  -