The association of calcium channel blockers with beta-cell function in type 2 diabetic patients: A cross-sectional study
The association of calcium channel blockers with beta-cell function in type 2 diabetic patients: A cross-sectional study
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钙通道阻滞剂与 2 型糖尿病患者 β 细胞功能的关联：一项横断面研究
DOI：
10.1111/jch.13517
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发表时间：
2019
影响因子：
2.8
通讯作者：
Feng Ying-Mei
中科院分区：
文献类型：
--
作者：
Zhao Dong;Cao Yu;Yu Cai-Guo;Yuan Sha-Sha;Zhang Ning;Zhang Yuan-Yuan;Staessen Jan A.;Feng Ying-Mei
2型糖尿病（T2 DM）患者常伴有高血压。然而，抗高血压药物与β细胞功能的相关性尚未得到充分研究。为了研究这个问题，作者进行了一项涉及882例高血压T2 DM患者的横断面研究。为了评估β细胞功能，患者口服75 g葡萄糖，并在葡萄糖摄入前和摄入后1、2和3小时测量C肽水平。通过稳态模型评估模型计算Homa-β，以使用血浆中的空腹C肽和葡萄糖水平评价β细胞功能。进行了多变量校正分析，以评价降压药物与C肽水平、HbA 1c和Homa-β的相关性。在882例高血压患者中，547例（62.0%）接受了降压治疗。多变量校正分析表明，钙通道阻滞剂（CCB）的使用与HbA 1c水平呈负相关（CCB：0. 95 [95% CI：0. 92 - 0. 98]，P= 0. 002）。我们的数据进一步表明，与非CCB使用者相比，使用CCB的T2 DM患者在OGTT前和OGTT 1、2和3小时的C肽水平分别增加了1.10、1.18、1.19和1.15倍（空腹C肽水平P= 0.084; OGTT后1、2和3小时的C肽水平P≤ 0.024）。然而，任何其他降压药物的使用与HbA 1c和C肽水平均不相关（P≥ 0.11）。总之，CCB治疗与高血压T2 DM患者的HbA 1c水平呈负相关，但与β细胞功能呈正相关，这意味着可以考虑使用CCB治疗β细胞功能降低的高血压T2 DM患者。
Type 2 diabetes mellitus (T2DM) patients are often accompanied with hypertension. However, the association of antihypertensive drugs with β‐cell function has not been well studied. To investigate this question, the authors performed a cross‐sectional study involving 882 hypertensive T2DM patients. To assess β‐cell function, patients were given 75g glucose orally and C‐peptide levels before and 1, 2, and 3 hours after glucose intake were measured. Homa‐β was computed by Homeostasis Model Assessment model to evaluate β‐cell function using fasting C‐peptide and glucose levels in the plasma. Multivariable‐adjusted analysis was performed to evaluate the association of antihypertensive drugs with C‐peptide levels, HbA1c, and Homa‐β. Among 882 hypertensive patients, 547 (62.0%) received antihypertensive treatment. Multivariate‐adjusted analysis demonstrated that use of calcium channel blockers (CCBs) was negatively associated with HbA1c levels (CCBs: 0.95 [95% CI: 0.92‐0.98],P= 0.002). Our data further illustrated that the C‐peptide levels before and 1, 2, and 3 hours of OGTT were 1.10‐, 1.18‐, 1.19‐, and 1.15‐fold increase in T2DM patients taking CCBs (P= 0.084 for fasting C‐peptide levels;P≤ 0.024 for C‐peptide levels at 1, 2, and 3 hours after OGTT) in comparison with non‐CCB users. Nevertheless, usage of any other antihypertensive drugs did neither associated with HbA1c nor associated with C‐peptide levels (P≥ 0.11). In conclusion, CCB treatment was negatively associated with HbA1c levels but positively associated with β‐cell function in hypertensive T2DM patients, implying that CCBs could be considered to treat hypertensive T2DM patients with reduced β‐cell function.