Biomarker-Guided Metformin Therapy for Growth Plate Senescence Prevention

Metformin prevents premature growth plate senescence in achondroplasia through AMPK-mediated autophagy activation and mTOR inhibition, extending the proliferative lifespan of growth plate chondrocytes. The drug reduces cellular senescence markers (p16, p21, SA-β-gal) while maintaining chondrocyte stemness through FOXO3 activation and mitochondrial quality control enhancement.