Metformin and all-cause mortality in older adults with type 2 diabetes mellitus and hypertension: National Health and Nutrition Examination Survey (NHANES) 1999–2018 evidence for albumin as a mediator
Main finding · All-cause mortalityResult — go to the resultHazard ratio 0.8 95 % CI 0.71–0.90Authors' conclusion
ALB mediates the association between metformin use and lower all-cause mortality in older Americans with T2DM and hypertension, underscoring the mortality-reducing importance of nutritional status.
Study context
- Population
- Older Americans with T2D and hypertension, NHANES, ten cycles
- Exposure
- Metformin use vs no metformin
- Outcome
- All-cause mortality
Methodological detailsretrospective longitudinal analysis, mediation analysis, NHANES ten cycles
- Retrospective longitudinal analysis
- Mediation analysis
- NHANES ten cycles
Main finding
As reported in the abstract
Hazard ratio
0.8
95 % CI 0.71–0.90
P < 0.001
Metforminvs No metformin
HR 0.8 (95 % CI 0.71–0.90); P < 0.001
- All-cause mortality, whole cohort
- 40.97 %
Observational data: associations, not effects.
Further findings
Mediation by albumin of metformin–mortality association
- Proportion of association mediated by albumin (ALB) (partial mediation)
- 13.32 % (P < 0.0001)
Original publication
Metformin and all-cause mortality in older adults with type 2 diabetes mellitus and hypertension: NHANES 1999–2018 evidence for albumin as a mediator. Diabetes Res Clin Pract. Published 22 December 2025. doi:10.
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