Wagner J A, Wright E C, Ennis M M, Prince M, Kochan J, Nunez D J R, Schneider B, Wang M-D, Chen Y, Ghosh S, Musser B J, Vassileva M T
Department of Clinical Pharmacology, Merck Research Laboratories, Rahway, New Jersey, USA.
Clin Pharmacol Ther. 2009 Dec;86(6):619-25. doi: 10.1038/clpt.2009.88. Epub 2009 Jun 24.
This study, conducted under the Metabolic Disorders Steering Committee of the Biomarkers Consortium (a public-private partnership managed by the Foundation for the National Institutes of Health (FNIH)), analyzed blinded data on 2,688 type 2 diabetes (T2D) patients from randomized clinical trials conducted by four pharmaceutical companies. An increase in the levels of adiponectin was observed after peroxisome proliferator-activated receptor (PPAR)-agonist treatment (P < 0.0001), but not after treatment with non-PPAR drugs. This increase correlated with decreases in levels of glucose, hemoglobin A(1c) (Hb(A1c)), hematocrit, and triglycerides, and increases in levels of blood urea nitrogen, creatinine, and high-density lipoprotein cholesterol (HDL-C). Early (6-8 weeks) increases in levels of adiponectin after treatment with PPAR agonists showed a negative correlation (r = -0.21, P < 0.0001) with subsequent changes in levels of Hb(A1c). Changes in adiponectin level did not appear to be associated with baseline level of Hb(A1c). Logistic regression demonstrated that an increase in the level of adiponectin predicts a decrease in the level of Hb(A1c). These analyses confirm previously demonstrated relationships between adiponectin levels and metabolic parameters and support the robust predictive utility of adiponectin across the spectrum of glucose tolerance. Cross-company precompetitive collaboration is a feasible and powerful approach to biomarker qualification.
这项研究由生物标志物联盟代谢紊乱指导委员会(由美国国立卫生研究院基金会(FNIH)管理的公私合营机构)开展,分析了来自四家制药公司进行的随机临床试验的2688例2型糖尿病(T2D)患者的盲态数据。过氧化物酶体增殖物激活受体(PPAR)激动剂治疗后脂联素水平升高(P<0.0001),但非PPAR药物治疗后未出现升高。这种升高与血糖、糖化血红蛋白(Hb(A1c))、血细胞比容和甘油三酯水平降低以及血尿素氮、肌酐和高密度脂蛋白胆固醇(HDL-C)水平升高相关。PPAR激动剂治疗后早期(6 - 8周)脂联素水平升高与随后Hb(A1c)水平变化呈负相关(r = -0.21,P<0.0001)。脂联素水平变化似乎与Hb(A1c)基线水平无关。逻辑回归表明脂联素水平升高预示着Hb(A1c)水平降低。这些分析证实了先前证明的脂联素水平与代谢参数之间的关系,并支持脂联素在整个糖耐量范围内具有强大的预测效用。跨公司的竞争前合作是生物标志物鉴定的一种可行且有力的方法。