Factors That Influence Pancreatic Beta Cell Function and Insulin Resistance in Newly Diagnosed Type 2 Diabetes Patients: A Sub-Analysis of the MARCH Trial.
Factors That Influence Pancreatic Beta Cell Function and Insulin Resistance in Newly Diagnosed Type 2 Diabetes Patients: A Sub-Analysis of the MARCH Trial.
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影响新诊断 2 型糖尿病患者胰腺 β 细胞功能和胰岛素抵抗的因素：MARCH 试验的亚分析
DOI：
10.1007/s13300-018-0393-5
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发表时间：
2018-04
期刊：
影响因子：
--
通讯作者：
Wang G
中科院分区：
文献类型：
--
作者：
Duan Y;Liu J;Xu Y;Yang N;Yang W;Wang G
二甲双胍和阿卡波糖在中国作为初始降糖治疗（MARCH）试验，已证明阿卡波糖和二甲双胍治疗新诊断的2型糖尿病（T2 DM）患者在降低HbA 1c方面具有相似的疗效。本研究对MARCH试验进行亚组分析，旨在评价阿卡波糖治疗对中国新诊断的2型糖尿病患者胰岛β细胞功能和胰岛素抵抗改善的影响。方法在784例进入MARCH试验的患者中，391例被分配到阿卡波糖治疗组;其中304例完成了48周的阿卡波糖治疗随访。在48周时，根据稳态模型评估-β细胞功能（β HOMA-β）和稳态模型评估-胰岛素抵抗的三分位数变化，结果HOMA-β改善程度高的患者收缩压（SBP）、餐后2 h血糖（PBG）、糖化血红蛋白（HbA 1c）、糖化血红蛋白（高密度脂蛋白胆固醇（HDL-c）、空腹血清胰岛素（FINS）浓度及HOMA-IR较低改善组降低（p< 0.05）。观察到HbA 1c、收缩压与Δ HOMA-β高度改善之间呈正相关（p< 0.05），而HDL-c与Δ HOMA-β高度改善之间呈明显负相关（p< 0.05）。HOMA-IR高度改善组的体重指数（BMI）、空腹血糖（FBG）、FINS浓度和HOMA-β显著高于低改善组（p< 0.05）。空腹血糖、腰围、和高度改进的HOMA-IR结论中国新诊断的T2 DM患者基线HDL-C水平较低，c和更高的HbA 1c和SBP值更有可能改善β细胞功能，而基线空腹血糖和腰围是阿卡波糖治疗改善胰岛素抵抗的重要因素。注册临床试验注册号为ChiCTR-TRC-08000231。
IntroductionThe Metformin and Acarbose in Chinese as the initial Hypoglycemic treatment (MARCH) trial has demonstrated a similar efficacy in HbA1c reduction between acarbose and metformin treatments in newly diagnosed type 2 diabetes mellitus (T2DM) patients. The current sub-analysis of the MARCH trail aims to evaluate the baseline characteristics that may influence the improvement of pancreatic β-cell function and insulin resistance after acarbose therapy in Chinese patients with newly diagnosed T2DM.MethodsOf the 784 patients who entered the MARCH trail, 391 were assigned to the acarbose therapy group; 304 of these completed 48 weeks of follow-up of acarbose therapy. At 48 weeks, on the basis of the tertiles of change in homeostasis model assessment–beta cell function (∆HOMA-β) and homeostasis model assessment–insulin resistance (∆HOMA-IR), the subjects were divided into lowly, mediumly, and highly improved groups.ResultsIn the highly improved HOMA-β group, patients had higher systolic blood pressure (SBP), 2-h postprandial blood glucose (PBG), hemoglobin A1c (HbA1c), and lower high-density lipoprotein cholesterol (HDL-c), fasting serum insulin (FINS) concentration, and HOMA-IR in comparison to the lowly improved group (p< 0.05). A positive correlation was observed between HbA1c, SBP, and highly improved ∆HOMA-β (p< 0.05), while an inverse correlation was evident between HDL-c and highly improved ∆HOMA-β (p< 0.05). The highly improved HOMA-IR group had a significantly higher body mass index (BMI), fasting blood glucose (FBG), FINS concentration, and HOMA-β in comparison to the lowly improved group (p< 0.05). A positive correlation was observed between FBG, waist circumference, and highly improved HOMA-IR (p< 0.05).ConclusionNewly diagnosed T2DM Chinese patients with lower baseline HDL-c and higher HbA1c and SBP values are more likely to achieve improvement in beta cell function whereas baseline fasting blood glucose and waist circumference were the significant factors associated with improvement in insulin resistance with acarbose therapy.Trial RegistrationThe clinical trial registry number was ChiCTR-TRC-08000231.
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影响因子：
5.1
作者：
Guariguata, L.;Whiting, D. R.;Shaw, J. E.
通讯作者：
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