{"id":"9c4ab1e7-f668-5aff-abda-ef1b860d66b3","stable_key":"8b3cf083-ea9c-54f5-b42b-bf1fef5b2978:metformin-acidosis-not-only-accumulation","predicate":"depends_on","statement":"Metformin-associated lactic acidosis was not necessarily due to metformin accumulation, true type B aerobic lactic acidosis seemed exceptional, and neither the severity of the clinical picture nor the degree of accumulation predicted survival.","claim_class":"observational","status":"source_derived_draft","evidence_grade":"ungraded","direction":"context_dependent","is_public":true,"mechanism_event_id":"765fe6fb-b38b-5e36-8fad-c3a696d77b28","mechanism_event_label":"The drug level alone did not decide who developed the acidosis or who survived it.","subject":{"id":"37adb9bc-cc62-5e54-af72-df8acba53fa0","slug":"metformin-associated-lactic-acidosis","display_name":"Metformin-associated lactic acidosis","entity_type_key":"cellular_process"},"object":{"id":"9d3f3434-82cd-5ce5-97e0-3f4ee8026f64","slug":"blood-lactate-concentration","display_name":"Blood lactate concentration","entity_type_key":"cellular_process"},"evidence_count":1,"mechanism_event":{"id":"765fe6fb-b38b-5e36-8fad-c3a696d77b28","stable_key":"8b3cf083-ea9c-54f5-b42b-bf1fef5b2978:metformin-acidosis-not-only-accumulation-event","event_type":"observed_intervention","label":"The drug level alone did not decide who developed the acidosis or who survived it.","description":"Metformin-associated lactic acidosis was not necessarily due to metformin accumulation, true type B aerobic lactic acidosis seemed exceptional, and neither the severity of the clinical picture nor the degree of accumulation predicted survival.","status":"provisional","compartment":null,"participants":[{"entity":{"id":"5ebd9a7c-b151-5b70-b70d-7d33067d4ebf","slug":"lactate","display_name":"L-Lactate","entity_type_key":"small_molecule"},"role":"measured_metabolite","stoichiometry":null,"state_label":"","sequence_order":0,"notes":""},{"entity":{"id":"37adb9bc-cc62-5e54-af72-df8acba53fa0","slug":"metformin-associated-lactic-acidosis","display_name":"Metformin-associated lactic acidosis","entity_type_key":"cellular_process"},"role":"subject","stoichiometry":null,"state_label":"","sequence_order":1,"notes":""},{"entity":{"id":"9d3f3434-82cd-5ce5-97e0-3f4ee8026f64","slug":"blood-lactate-concentration","display_name":"Blood lactate concentration","entity_type_key":"cellular_process"},"role":"target","stoichiometry":null,"state_label":"","sequence_order":2,"notes":""}]},"contexts":[{"dimension":"availability_state","value_text":"biomarker_context","comparator":null,"unit":null,"notes":"Imported condition classification; unverified.","entity":null},{"dimension":"evidence_span","value_text":"{\"source_cache\": \"artifacts/metformin-research/7555503.abstract.txt\", \"locator\": \"Indexed abstract; zero-based, end-exclusive Unicode character offsets\", \"file_sha256\": \"c960785146be30aa07921ceef25600c044dd421566e708cdc5c45bffccb0e301\", \"start_char\": 0, \"end_char\": 2221, \"text_sha256\": \"c960785146be30aa07921ceef25600c044dd421566e708cdc5c45bffccb0e301\"}","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"experimental_model","value_text":"Plasma metformin measurement by HPLC in 14 people with lactic acidosis during metformin treatment","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"exposure","value_text":"Chronic metformin with intercurrent renal failure","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"limitations","value_text":"A case series in an intensive-care setting. It argues against a simple dose-toxicity relationship; the numbers are small.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"nutrient_topic","value_text":"Metformin research collection; topical membership is not evidence of a direct clinical effect, and pharmacological exposure is not dietary intake.","comparator":null,"unit":null,"notes":"","entity":{"slug":"metformin","display_name":"Metformin","entity_type_key":"drug"}},{"dimension":"organism","value_text":"Human","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"plain_language","value_text":"The drug level alone did not decide who developed the acidosis or who survived it.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"primary_references","value_text":"[metformin-p7555503] Role of metformin accumulation in metformin-associated lactic acidosis. (1995). https://pubmed.ncbi.nlm.nih.gov/7555503/ DOI: 10.2337/diacare.18.6.779","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"tissue_or_cell_type","value_text":"Whole body","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"trigger_kind","value_text":"biomarker_context","comparator":null,"unit":null,"notes":"Imported condition classification; unverified.","entity":null}],"evidence":[{"id":"4d9cbc50-243a-5c13-8b9e-968f97b0b856","evidence_kind":"source_excerpt","locator":"Lines 1438-1449","start_line":1438,"end_line":1449,"excerpt":"### metformin-acidosis-not-only-accumulation\nMetformin-associated lactic acidosis was not necessarily due to metformin accumulation, true type B aerobic lactic acidosis seemed exceptional, and neither the severity of the clinical picture nor the degree of accumulation predicted survival.\nCondition category: biomarker_context\nnutrient_topic: Metformin research collection; topical membership is not evidence of a direct clinical effect, and pharmacological exposure is not dietary intake.\nplain_language: The drug level alone did not decide who developed the acidosis or who survived it.\norganism: Human\ntissue_or_cell_type: Whole body\nexperimental_model: Plasma metformin measurement by HPLC in 14 people with lactic acidosis during metformin treatment\nlimitations: A case series in an intensive-care setting. It argues against a simple dose-toxicity relationship; the numbers are small.\nexposure: Chronic metformin with intercurrent renal failure\nevidence_span: {\"source_cache\": \"artifacts/metformin-research/7555503.abstract.txt\", \"locator\": \"Indexed abstract; zero-based, end-exclusive Unicode character offsets\", \"file_sha256\": \"c960785146be30aa07921ceef25600c044dd421566e708cdc5c45bffccb0e301\", \"start_char\": 0, \"end_char\": 2221, \"text_sha256\": \"c960785146be30aa07921ceef25600c044dd421566e708cdc5c45bffccb0e301\"}\n[metformin-p7555503] Role of metformin accumulation in metformin-associated lactic acidosis. (1995). https://pubmed.ncbi.nlm.nih.gov/7555503/ DOI: 10.2337/diacare.18.6.779","model_system":"Plasma metformin measurement by HPLC in 14 people with lactic acidosis during metformin treatment","directness":"author_interpretation","verification_status":"source_derived_draft","notes":"Exact curation-document quotation, not publisher quotation. Study references: [metformin-p7555503] Role of metformin accumulation in metformin-associated lactic acidosis. (1995). https://pubmed.ncbi.nlm.nih.gov/7555503/ DOI: 10.2337/diacare.18.6.779","relationship":"supports","weight":1.0,"link_notes":"","source":{"id":"d0474bd9-7cfd-5695-a152-12f3633a6813","stable_key":"import-8b3cf083-ea9c-54f5-b42b-bf1fef5b2978","title":"Metformin: transport, molecular targets, gut mechanisms and nutrient interactions (2026-09-19)","document_type":"imported_text","citation_label":"AI-assisted literature curation; primary study URLs and scope retained in the document and extraction. Not publisher full text.","file_path":"","sha256":"0b51d0759aeeb88ac5b3a6277245a196b2bb024d7c32ec89379ed428fb06bfb5","revision_id":"0405c75e-f06e-5af7-a642-1777802f6004","review_status":"unverified_draft","notes":""}}],"relations":[],"conflicts":[],"corrections":[],"research":null}