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Metformin use and associated risk of total joint replacement in patients with type 2 diabetes: a population-based matched cohort study
Zhaohua Zhu, Jing-Yang Huang, Guangfeng Ruan, Peihua Cao, Shibo Chen, Yan Zhang, Weiyu Han, Tianyu Chen, Xiaoyan Cai, Jia Liu, Yujin Tang, Na Yu, Qian Wang, David J. Hunter, James Cheng-Chung Wei and Changhai Ding
CMAJ December 19, 2022 194 (49) E1672-E1684; DOI: https://doi.org/10.1503/cmaj.220952
Zhaohua Zhu
Clinical Research and Orthopedic Centres (Zhu, Cao, S. Chen, Zhang, Han, T. Chen, Wang, Hunter, Ding), Zhujiang Hospital, Southern Medical University, Guangzhou, China; Department of Medical Research (Huang), Chung Shan Medical University Hospital; Institute of Medicine (Huang, Wei), Chung Shan Medical University, Taichung, Taiwan; Clinical Research Centre (Ruan), Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China; Department of Rheumatology (Cai, Ding), Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China; Department of Orthopedics (Liu, Tang, Ding), Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China; Guangzhou Eighth People’s Hospital (Yu), Guangzhou Medical University, Guangzhou, Guangdong, China; Department of Rheumatology (Hunter), Royal North Shore Hospital and Sydney Musculoskeletal Health, Kolling Institute, University of Sydney, Sydney, Australia; Department of Medicine (Wei), Chung Shan Medical University Hospital; Graduate Institute of Integrated Medicine (Wei), China Medical University; Department of Medical Research (Wei), Taichung Veterans General Hospital, Taichung, Taiwan; Menzies Institute for Medical Research (Ding), University of Tasmania, Hobart, Australia
PhDJing-Yang Huang
Clinical Research and Orthopedic Centres (Zhu, Cao, S. Chen, Zhang, Han, T. Chen, Wang, Hunter, Ding), Zhujiang Hospital, Southern Medical University, Guangzhou, China; Department of Medical Research (Huang), Chung Shan Medical University Hospital; Institute of Medicine (Huang, Wei), Chung Shan Medical University, Taichung, Taiwan; Clinical Research Centre (Ruan), Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China; Department of Rheumatology (Cai, Ding), Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China; Department of Orthopedics (Liu, Tang, Ding), Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China; Guangzhou Eighth People’s Hospital (Yu), Guangzhou Medical University, Guangzhou, Guangdong, China; Department of Rheumatology (Hunter), Royal North Shore Hospital and Sydney Musculoskeletal Health, Kolling Institute, University of Sydney, Sydney, Australia; Department of Medicine (Wei), Chung Shan Medical University Hospital; Graduate Institute of Integrated Medicine (Wei), China Medical University; Department of Medical Research (Wei), Taichung Veterans General Hospital, Taichung, Taiwan; Menzies Institute for Medical Research (Ding), University of Tasmania, Hobart, Australia
PhDGuangfeng Ruan
Clinical Research and Orthopedic Centres (Zhu, Cao, S. Chen, Zhang, Han, T. Chen, Wang, Hunter, Ding), Zhujiang Hospital, Southern Medical University, Guangzhou, China; Department of Medical Research (Huang), Chung Shan Medical University Hospital; Institute of Medicine (Huang, Wei), Chung Shan Medical University, Taichung, Taiwan; Clinical Research Centre (Ruan), Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China; Department of Rheumatology (Cai, Ding), Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China; Department of Orthopedics (Liu, Tang, Ding), Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China; Guangzhou Eighth People’s Hospital (Yu), Guangzhou Medical University, Guangzhou, Guangdong, China; Department of Rheumatology (Hunter), Royal North Shore Hospital and Sydney Musculoskeletal Health, Kolling Institute, University of Sydney, Sydney, Australia; Department of Medicine (Wei), Chung Shan Medical University Hospital; Graduate Institute of Integrated Medicine (Wei), China Medical University; Department of Medical Research (Wei), Taichung Veterans General Hospital, Taichung, Taiwan; Menzies Institute for Medical Research (Ding), University of Tasmania, Hobart, Australia
MDPeihua Cao
Clinical Research and Orthopedic Centres (Zhu, Cao, S. Chen, Zhang, Han, T. Chen, Wang, Hunter, Ding), Zhujiang Hospital, Southern Medical University, Guangzhou, China; Department of Medical Research (Huang), Chung Shan Medical University Hospital; Institute of Medicine (Huang, Wei), Chung Shan Medical University, Taichung, Taiwan; Clinical Research Centre (Ruan), Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China; Department of Rheumatology (Cai, Ding), Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China; Department of Orthopedics (Liu, Tang, Ding), Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China; Guangzhou Eighth People’s Hospital (Yu), Guangzhou Medical University, Guangzhou, Guangdong, China; Department of Rheumatology (Hunter), Royal North Shore Hospital and Sydney Musculoskeletal Health, Kolling Institute, University of Sydney, Sydney, Australia; Department of Medicine (Wei), Chung Shan Medical University Hospital; Graduate Institute of Integrated Medicine (Wei), China Medical University; Department of Medical Research (Wei), Taichung Veterans General Hospital, Taichung, Taiwan; Menzies Institute for Medical Research (Ding), University of Tasmania, Hobart, Australia
PhDShibo Chen
Clinical Research and Orthopedic Centres (Zhu, Cao, S. Chen, Zhang, Han, T. Chen, Wang, Hunter, Ding), Zhujiang Hospital, Southern Medical University, Guangzhou, China; Department of Medical Research (Huang), Chung Shan Medical University Hospital; Institute of Medicine (Huang, Wei), Chung Shan Medical University, Taichung, Taiwan; Clinical Research Centre (Ruan), Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China; Department of Rheumatology (Cai, Ding), Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China; Department of Orthopedics (Liu, Tang, Ding), Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China; Guangzhou Eighth People’s Hospital (Yu), Guangzhou Medical University, Guangzhou, Guangdong, China; Department of Rheumatology (Hunter), Royal North Shore Hospital and Sydney Musculoskeletal Health, Kolling Institute, University of Sydney, Sydney, Australia; Department of Medicine (Wei), Chung Shan Medical University Hospital; Graduate Institute of Integrated Medicine (Wei), China Medical University; Department of Medical Research (Wei), Taichung Veterans General Hospital, Taichung, Taiwan; Menzies Institute for Medical Research (Ding), University of Tasmania, Hobart, Australia
MMedYan Zhang
Clinical Research and Orthopedic Centres (Zhu, Cao, S. Chen, Zhang, Han, T. Chen, Wang, Hunter, Ding), Zhujiang Hospital, Southern Medical University, Guangzhou, China; Department of Medical Research (Huang), Chung Shan Medical University Hospital; Institute of Medicine (Huang, Wei), Chung Shan Medical University, Taichung, Taiwan; Clinical Research Centre (Ruan), Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China; Department of Rheumatology (Cai, Ding), Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China; Department of Orthopedics (Liu, Tang, Ding), Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China; Guangzhou Eighth People’s Hospital (Yu), Guangzhou Medical University, Guangzhou, Guangdong, China; Department of Rheumatology (Hunter), Royal North Shore Hospital and Sydney Musculoskeletal Health, Kolling Institute, University of Sydney, Sydney, Australia; Department of Medicine (Wei), Chung Shan Medical University Hospital; Graduate Institute of Integrated Medicine (Wei), China Medical University; Department of Medical Research (Wei), Taichung Veterans General Hospital, Taichung, Taiwan; Menzies Institute for Medical Research (Ding), University of Tasmania, Hobart, Australia
PhDWeiyu Han
Clinical Research and Orthopedic Centres (Zhu, Cao, S. Chen, Zhang, Han, T. Chen, Wang, Hunter, Ding), Zhujiang Hospital, Southern Medical University, Guangzhou, China; Department of Medical Research (Huang), Chung Shan Medical University Hospital; Institute of Medicine (Huang, Wei), Chung Shan Medical University, Taichung, Taiwan; Clinical Research Centre (Ruan), Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China; Department of Rheumatology (Cai, Ding), Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China; Department of Orthopedics (Liu, Tang, Ding), Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China; Guangzhou Eighth People’s Hospital (Yu), Guangzhou Medical University, Guangzhou, Guangdong, China; Department of Rheumatology (Hunter), Royal North Shore Hospital and Sydney Musculoskeletal Health, Kolling Institute, University of Sydney, Sydney, Australia; Department of Medicine (Wei), Chung Shan Medical University Hospital; Graduate Institute of Integrated Medicine (Wei), China Medical University; Department of Medical Research (Wei), Taichung Veterans General Hospital, Taichung, Taiwan; Menzies Institute for Medical Research (Ding), University of Tasmania, Hobart, Australia
MD PhDTianyu Chen
Clinical Research and Orthopedic Centres (Zhu, Cao, S. Chen, Zhang, Han, T. Chen, Wang, Hunter, Ding), Zhujiang Hospital, Southern Medical University, Guangzhou, China; Department of Medical Research (Huang), Chung Shan Medical University Hospital; Institute of Medicine (Huang, Wei), Chung Shan Medical University, Taichung, Taiwan; Clinical Research Centre (Ruan), Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China; Department of Rheumatology (Cai, Ding), Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China; Department of Orthopedics (Liu, Tang, Ding), Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China; Guangzhou Eighth People’s Hospital (Yu), Guangzhou Medical University, Guangzhou, Guangdong, China; Department of Rheumatology (Hunter), Royal North Shore Hospital and Sydney Musculoskeletal Health, Kolling Institute, University of Sydney, Sydney, Australia; Department of Medicine (Wei), Chung Shan Medical University Hospital; Graduate Institute of Integrated Medicine (Wei), China Medical University; Department of Medical Research (Wei), Taichung Veterans General Hospital, Taichung, Taiwan; Menzies Institute for Medical Research (Ding), University of Tasmania, Hobart, Australia
MDXiaoyan Cai
Clinical Research and Orthopedic Centres (Zhu, Cao, S. Chen, Zhang, Han, T. Chen, Wang, Hunter, Ding), Zhujiang Hospital, Southern Medical University, Guangzhou, China; Department of Medical Research (Huang), Chung Shan Medical University Hospital; Institute of Medicine (Huang, Wei), Chung Shan Medical University, Taichung, Taiwan; Clinical Research Centre (Ruan), Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China; Department of Rheumatology (Cai, Ding), Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China; Department of Orthopedics (Liu, Tang, Ding), Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China; Guangzhou Eighth People’s Hospital (Yu), Guangzhou Medical University, Guangzhou, Guangdong, China; Department of Rheumatology (Hunter), Royal North Shore Hospital and Sydney Musculoskeletal Health, Kolling Institute, University of Sydney, Sydney, Australia; Department of Medicine (Wei), Chung Shan Medical University Hospital; Graduate Institute of Integrated Medicine (Wei), China Medical University; Department of Medical Research (Wei), Taichung Veterans General Hospital, Taichung, Taiwan; Menzies Institute for Medical Research (Ding), University of Tasmania, Hobart, Australia
MDJia Liu
Clinical Research and Orthopedic Centres (Zhu, Cao, S. Chen, Zhang, Han, T. Chen, Wang, Hunter, Ding), Zhujiang Hospital, Southern Medical University, Guangzhou, China; Department of Medical Research (Huang), Chung Shan Medical University Hospital; Institute of Medicine (Huang, Wei), Chung Shan Medical University, Taichung, Taiwan; Clinical Research Centre (Ruan), Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China; Department of Rheumatology (Cai, Ding), Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China; Department of Orthopedics (Liu, Tang, Ding), Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China; Guangzhou Eighth People’s Hospital (Yu), Guangzhou Medical University, Guangzhou, Guangdong, China; Department of Rheumatology (Hunter), Royal North Shore Hospital and Sydney Musculoskeletal Health, Kolling Institute, University of Sydney, Sydney, Australia; Department of Medicine (Wei), Chung Shan Medical University Hospital; Graduate Institute of Integrated Medicine (Wei), China Medical University; Department of Medical Research (Wei), Taichung Veterans General Hospital, Taichung, Taiwan; Menzies Institute for Medical Research (Ding), University of Tasmania, Hobart, Australia
MDYujin Tang
Clinical Research and Orthopedic Centres (Zhu, Cao, S. Chen, Zhang, Han, T. Chen, Wang, Hunter, Ding), Zhujiang Hospital, Southern Medical University, Guangzhou, China; Department of Medical Research (Huang), Chung Shan Medical University Hospital; Institute of Medicine (Huang, Wei), Chung Shan Medical University, Taichung, Taiwan; Clinical Research Centre (Ruan), Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China; Department of Rheumatology (Cai, Ding), Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China; Department of Orthopedics (Liu, Tang, Ding), Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China; Guangzhou Eighth People’s Hospital (Yu), Guangzhou Medical University, Guangzhou, Guangdong, China; Department of Rheumatology (Hunter), Royal North Shore Hospital and Sydney Musculoskeletal Health, Kolling Institute, University of Sydney, Sydney, Australia; Department of Medicine (Wei), Chung Shan Medical University Hospital; Graduate Institute of Integrated Medicine (Wei), China Medical University; Department of Medical Research (Wei), Taichung Veterans General Hospital, Taichung, Taiwan; Menzies Institute for Medical Research (Ding), University of Tasmania, Hobart, Australia
MDNa Yu
Clinical Research and Orthopedic Centres (Zhu, Cao, S. Chen, Zhang, Han, T. Chen, Wang, Hunter, Ding), Zhujiang Hospital, Southern Medical University, Guangzhou, China; Department of Medical Research (Huang), Chung Shan Medical University Hospital; Institute of Medicine (Huang, Wei), Chung Shan Medical University, Taichung, Taiwan; Clinical Research Centre (Ruan), Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China; Department of Rheumatology (Cai, Ding), Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China; Department of Orthopedics (Liu, Tang, Ding), Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China; Guangzhou Eighth People’s Hospital (Yu), Guangzhou Medical University, Guangzhou, Guangdong, China; Department of Rheumatology (Hunter), Royal North Shore Hospital and Sydney Musculoskeletal Health, Kolling Institute, University of Sydney, Sydney, Australia; Department of Medicine (Wei), Chung Shan Medical University Hospital; Graduate Institute of Integrated Medicine (Wei), China Medical University; Department of Medical Research (Wei), Taichung Veterans General Hospital, Taichung, Taiwan; Menzies Institute for Medical Research (Ding), University of Tasmania, Hobart, Australia
MDQian Wang
Clinical Research and Orthopedic Centres (Zhu, Cao, S. Chen, Zhang, Han, T. Chen, Wang, Hunter, Ding), Zhujiang Hospital, Southern Medical University, Guangzhou, China; Department of Medical Research (Huang), Chung Shan Medical University Hospital; Institute of Medicine (Huang, Wei), Chung Shan Medical University, Taichung, Taiwan; Clinical Research Centre (Ruan), Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China; Department of Rheumatology (Cai, Ding), Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China; Department of Orthopedics (Liu, Tang, Ding), Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China; Guangzhou Eighth People’s Hospital (Yu), Guangzhou Medical University, Guangzhou, Guangdong, China; Department of Rheumatology (Hunter), Royal North Shore Hospital and Sydney Musculoskeletal Health, Kolling Institute, University of Sydney, Sydney, Australia; Department of Medicine (Wei), Chung Shan Medical University Hospital; Graduate Institute of Integrated Medicine (Wei), China Medical University; Department of Medical Research (Wei), Taichung Veterans General Hospital, Taichung, Taiwan; Menzies Institute for Medical Research (Ding), University of Tasmania, Hobart, Australia
MD PhDDavid J. Hunter
Clinical Research and Orthopedic Centres (Zhu, Cao, S. Chen, Zhang, Han, T. Chen, Wang, Hunter, Ding), Zhujiang Hospital, Southern Medical University, Guangzhou, China; Department of Medical Research (Huang), Chung Shan Medical University Hospital; Institute of Medicine (Huang, Wei), Chung Shan Medical University, Taichung, Taiwan; Clinical Research Centre (Ruan), Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China; Department of Rheumatology (Cai, Ding), Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China; Department of Orthopedics (Liu, Tang, Ding), Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China; Guangzhou Eighth People’s Hospital (Yu), Guangzhou Medical University, Guangzhou, Guangdong, China; Department of Rheumatology (Hunter), Royal North Shore Hospital and Sydney Musculoskeletal Health, Kolling Institute, University of Sydney, Sydney, Australia; Department of Medicine (Wei), Chung Shan Medical University Hospital; Graduate Institute of Integrated Medicine (Wei), China Medical University; Department of Medical Research (Wei), Taichung Veterans General Hospital, Taichung, Taiwan; Menzies Institute for Medical Research (Ding), University of Tasmania, Hobart, Australia
MD PhDJames Cheng-Chung Wei
Clinical Research and Orthopedic Centres (Zhu, Cao, S. Chen, Zhang, Han, T. Chen, Wang, Hunter, Ding), Zhujiang Hospital, Southern Medical University, Guangzhou, China; Department of Medical Research (Huang), Chung Shan Medical University Hospital; Institute of Medicine (Huang, Wei), Chung Shan Medical University, Taichung, Taiwan; Clinical Research Centre (Ruan), Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China; Department of Rheumatology (Cai, Ding), Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China; Department of Orthopedics (Liu, Tang, Ding), Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China; Guangzhou Eighth People’s Hospital (Yu), Guangzhou Medical University, Guangzhou, Guangdong, China; Department of Rheumatology (Hunter), Royal North Shore Hospital and Sydney Musculoskeletal Health, Kolling Institute, University of Sydney, Sydney, Australia; Department of Medicine (Wei), Chung Shan Medical University Hospital; Graduate Institute of Integrated Medicine (Wei), China Medical University; Department of Medical Research (Wei), Taichung Veterans General Hospital, Taichung, Taiwan; Menzies Institute for Medical Research (Ding), University of Tasmania, Hobart, Australia
MD PhDChanghai Ding
Clinical Research and Orthopedic Centres (Zhu, Cao, S. Chen, Zhang, Han, T. Chen, Wang, Hunter, Ding), Zhujiang Hospital, Southern Medical University, Guangzhou, China; Department of Medical Research (Huang), Chung Shan Medical University Hospital; Institute of Medicine (Huang, Wei), Chung Shan Medical University, Taichung, Taiwan; Clinical Research Centre (Ruan), Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China; Department of Rheumatology (Cai, Ding), Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China; Department of Orthopedics (Liu, Tang, Ding), Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China; Guangzhou Eighth People’s Hospital (Yu), Guangzhou Medical University, Guangzhou, Guangdong, China; Department of Rheumatology (Hunter), Royal North Shore Hospital and Sydney Musculoskeletal Health, Kolling Institute, University of Sydney, Sydney, Australia; Department of Medicine (Wei), Chung Shan Medical University Hospital; Graduate Institute of Integrated Medicine (Wei), China Medical University; Department of Medical Research (Wei), Taichung Veterans General Hospital, Taichung, Taiwan; Menzies Institute for Medical Research (Ding), University of Tasmania, Hobart, Australia
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Metformin use and associated risk of total joint replacement in patients with type 2 diabetes: a population-based matched cohort study
Zhaohua Zhu, Jing-Yang Huang, Guangfeng Ruan, Peihua Cao, Shibo Chen, Yan Zhang, Weiyu Han, Tianyu Chen, Xiaoyan Cai, Jia Liu, Yujin Tang, Na Yu, Qian Wang, David J. Hunter, James Cheng-Chung Wei, Changhai Ding
CMAJ Dec 2022, 194 (49) E1672-E1684; DOI: 10.1503/cmaj.220952
Metformin use and associated risk of total joint replacement in patients with type 2 diabetes: a population-based matched cohort study
Zhaohua Zhu, Jing-Yang Huang, Guangfeng Ruan, Peihua Cao, Shibo Chen, Yan Zhang, Weiyu Han, Tianyu Chen, Xiaoyan Cai, Jia Liu, Yujin Tang, Na Yu, Qian Wang, David J. Hunter, James Cheng-Chung Wei, Changhai Ding
CMAJ Dec 2022, 194 (49) E1672-E1684; DOI: 10.1503/cmaj.220952
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