Blood Glucagon Levels Predict the Hemoglobin A1c Response to Saxagliptin in Patients with Type 2 Diabetes Inadequately Controlled with Metformin.
Blood Glucagon Levels Predict the Hemoglobin A1c Response to Saxagliptin in Patients with Type 2 Diabetes Inadequately Controlled with Metformin.
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血糖浓度可预测二甲双胍控制不佳的 2 型糖尿病患者对沙格列汀的血红蛋白 A1c 反应
DOI：
10.1007/s13300-016-0200-0
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发表时间：
2016-12
期刊：
影响因子：
3.8
通讯作者：
Ma, Jian-hua
中科院分区：
文献类型：
--
作者：
Liu, Hao;Hu, Yun;Li, Feng-fei;Liu, Bing-li;Su, Xiao-fei;Ma, Jian-hua
二肽基肽酶 4 (DPP-4) 抑制剂被广泛用作二甲双胍失效时的第二选择药物。已观察到 2 型糖尿病 (T2DM) 患者糖化血红蛋白 (HbA1c) 对 DPP-4 抑制反应的差异，但预测对 DPP-4 抑制剂治疗反应的特征尚不清楚。本研究的目的是研究 α 和 β 细胞功能的特征，这些特征可能预测沙格列汀的疗效并促进个性化治疗。我们研究了 60 名 T2DM 患者，他们单用二甲双胍血糖控制不足 [HbA1c7.0–13.0% (53–119 mmol/mol)]。患者接受沙格列汀（每日 5 毫克）和二甲双胍（前者 1000-2000 毫克）治疗 12 周。在基线和终点进行口服葡萄糖耐量试验以评估α细胞和β细胞功能，并测试血液C肽、胰岛素、胰高血糖素水平。还观察血糖、HbA1c 和体重。治疗 12 周后，观察到体重、HbA1c 和胰高血糖素显着下降，而 C 肽、胰岛素和稳态模型评估-β 则增加 (P < 0.05)。线性回归和受试者操作特征分析表明，基线 HbA1c 和 30 分钟胰高血糖素与 HbA1c 对沙格列汀的反应相关，而体重减轻与性别、年龄和空腹胰岛素水平相关。进一步分析表明，30 分钟胰高血糖素 49.1 pmol/L 是预测沙格列汀疗效的最佳截止值。添加到二甲双胍中的沙格列汀可显着改善血糖控制以及 α 和 β 细胞功能。血糖水平是沙格列汀 HbA1c 反应的良好预测因素，有助于适当的患者选择。中国临床试验注册标识符，ChiCTR-PPR-15007045。
Dipeptidyl peptidase-4 (DPP-4) inhibitors are widely used as second-option medications when metformin fails. Variance of the glycated hemoglobin (HbA1c) response to DPP-4 inhibitions in patients with type 2 diabetes mellitus (T2DM) has been observed, but the characteristics which predict the response to DPP-4 inhibitor therapy are unclear. The aim of this study was to investigate the characteristics of α- and β-cell functions which might predict the efficacy of saxagliptin and facilitate personalization of treatment. We studied 60 patients with T2DM who had inadequate glycemic control [HbA1c7.0–13.0% (53–119 mmol/mol)) with metformin alone. The patients were treated with saxagliptin (5 mg, daily) and metformin (1000–2000 mg as former) for 12 weeks. Oral glucose tolerance tests were carried out at baseline and endpoint to evaluate α- and β-cell functions, and blood C-peptide, insulin, glucagon levels were tested. Blood glucose, HbA1c and weight were also observed. Significant reduction of weight, HbA1c and glucagon was observed after 12-week treatment, while C-peptide, insulin and homeostasis model assessment-β increased (P < 0.05). Linear regression and receiver operating characteristic analysis showed that baseline HbA1c and 30 min-glucagon were correlated with the HbA1c response to saxagliptin, while the weight loss was correlated with gender, age and fasting-insulin level. Further analysis showed the 30 min-glucagon of 49.1 pmol/L was the optimal cutoff value to predict the efficacy of saxagliptin. Saxagliptin added to metformin significantly improved glycemic control and α- and β-cell function. Blood glucagon level was a good predicting factor for the HbA1c response to saxagliptin, and it will help appropriate patient selection. Chinese Clinical Trial Register identifier, ChiCTR-PPR-15007045.
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影响因子：
8
作者：
Pan, Chang Yu;Yang, Wenying;Zhao, June
通讯作者：
Zhao, June
影响因子：
5.8
作者：
Esposito, K.;Cozzolino, D.;Giugliano, D.
通讯作者：
Giugliano, D.
影响因子：
5.8
作者：
Hollander, Priscilla;Li, Jia;Chen, Roland
通讯作者：
Chen, Roland
影响因子：
4.5
作者：
Dayeh T;Volkov P;Salö S;Hall E;Nilsson E;Olsson AH;Kirkpatrick CL;Wollheim CB;Eliasson L;Rönn T;Bacos K;Ling C
通讯作者：
Ling C
影响因子：
2
作者：
Otsuka, Yuichiro;Yamaguchi, Suguru;Ishihara, Hisamitsu
通讯作者：
Ishihara, Hisamitsu