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- Title
二甲双胍的降糖作用与腰围而非体质指数相关:MARCH研究亚组分析.
- Authors
王昕; 杨兆军; 王娜; 金仙; 张金苹; 李照青; 张雪莲; 杨文英
- Abstract
Objective The purpose of this paper was to understand the association between the efficacy of acarbose or metformin and the parameters reflected body weight, such as body mass index (BMI), central obesity (COB), magnitude of weight loss. Methods A total of 788 participants from MARCH database were included in this analysis. After a 4⁃week run⁃in period of lifestyle modification, patients were assigned to 48 weeks of therapy with metformin or acarbose as the initial treatment. The participants were divided into four BMI groups (BMI 19.0-23.9, 24.0-25.9, 26.0-27.9, and 28.0-30.0 kg/m2) and two central obesity groups according to IDF criteria (i. e. waist circumference ≥90 cm in male, ≥80 cm in female), respectively. ANCOVA was used to assess the association of the above obesity categories with the changes of glycated hemoglobin A1c (HbA1c) from baseline in acarbose group and metformin group respectively, with treatment and center as factors, and baseline HbA1c as a covariate. Results There was no significant difference in change from baseline HbA1c within the acarbose groups (0.98%±0.09%, 0.95%± 0.09%, 1.20%±0.09%, 1.14%±0.10%, F=1.80, P>0.05) as well as the metformin groups (1.08%±0.09%, 1.12% ± 0.09%, 1.20% ± 0.10%, 1.32% ± 0.10%, F=1.25, P>0.05) when patients were stratified by BMI quartile. The reduction in HbA1c was greater in patients with central obesity than those without in metformin group (1.26%±0.06% vs 0.98%±0.08%, F=7.68, P<0.05), but there was no significant difference among patients with and without central obesity for HbA1c reduction in acarbose treatment group (1.10%±0.06% vs 0.97%±0.08%, F=1.62, P>0.05). Conclusion The hypoglycemic efficacy of acarbose was not associated with the obesity status. In contrast, metformin was more effective in diabetic patients with central obesity.
- Publication
Chinese Journal of Diabetes Mellitus, 2018, Vol 10, Issue 12, p773
- ISSN
1674-5809
- Publication type
Article
- DOI
10.3760/cma.j.issn.1674-5809.2018.12.004