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新型双重过氧化物酶体增殖物激活受体 α/δ 激动剂 GFT505 对合并血脂异常或糖代谢受损的腹型肥胖患者脂糖代谢的影响。

Effects of the new dual PPAR α/δ agonist GFT505 on lipid and glucose homeostasis in abdominally obese patients with combined dyslipidemia or impaired glucose metabolism.

机构信息

Department of Endocrinology, L'institut du Thorax, Nantes University Hospital, Nantes, France.

出版信息

Diabetes Care. 2011 Sep;34(9):2008-14. doi: 10.2337/dc11-0093. Epub 2011 Aug 4.

Abstract

OBJECTIVE

We evaluated the metabolic effects and tolerability of GFT505, a novel dual peroxisome proliferator-activated receptor α/δ agonist, in abdominally obese patients with either combined dyslipidemia or prediabetes.

RESEARCH DESIGN AND METHODS

The S1 study was conducted in 94 patients with combined dyslipidemia while the S2 study was conducted in 47 patients with prediabetes. Participants were randomly assigned in a double-blind manner to GFT505 at 80 mg/day or placebo for 28 (S1) or 35 (S2) days. Primary efficacy end points were changes from baseline at week 4 in both fasting plasma triglycerides and HDL cholesterol in the S1 group and 2-h glucose upon oral glucose tolerance test in the S2 group.

RESULTS

In comparison with placebo, GFT505 significantly reduced fasting plasma triglycerides (S1: least squares means -16.7% [95% one-sided CI -∞ to -5.3], P = 0.005; S2: -24.8% [-∞ to -10.5], P = 0.0003) and increased HDL cholesterol (S1: 7.8% [3.0 to ∞], P = 0.004; S2: 9.3% [1.7 to ∞], P = 0.009) in both studies, whereas LDL cholesterol only decreased in S2 (-11.0% [ -∞ to -3.5], P = 0.002). In S2, GFT505 did not reduce 2-h glucose (-0.52 mmol/L [-∞ to 0.61], P = 0.18) but led to a significant decrease of homeostasis model assessment of insulin resistance (-31.4% [-∞ to 12.5], P = 0.001), fasting plasma glucose (-0.37 mmol/L [-∞ to -0.10], P = 0.01) and fructosamine (-3.6% [-∞ to -0.20], P = 0.02). GFT505 also reduced γ glutamyl transferase levels in both studies (S1: -19.9% [-∞ to -12.8], P < 0.0001; S2: -15.1% [-∞ to -1.1], P = 0.004). No specific adverse safety signals were reported during the studies.

CONCLUSIONS

GFT505 may be considered a new drug candidate for the treatment of lipid and glucose disorders associated with the metabolic syndrome.

摘要

目的

我们评估了新型双重过氧化物酶体增殖物激活受体α/δ激动剂 GFT505 对合并血脂异常或糖尿病前期的腹型肥胖患者的代谢影响和耐受性。

研究设计和方法

S1 研究纳入 94 例合并血脂异常的患者,S2 研究纳入 47 例糖尿病前期患者。采用双盲法将患者随机分配至 GFT505 80mg/天或安慰剂组,治疗 28 天(S1 组)或 35 天(S2 组)。主要疗效终点为 S1 组第 4 周空腹血浆甘油三酯和高密度脂蛋白胆固醇较基线的变化,以及 S2 组口服葡萄糖耐量试验时 2 小时血糖。

结果

与安慰剂相比,GFT505 可显著降低空腹血浆甘油三酯(S1:最小二乘均值-16.7%[95%单侧 CI-∞至-5.3],P=0.005;S2:-24.8%[-∞至-10.5],P=0.0003)和升高高密度脂蛋白胆固醇(S1:7.8%[3.0 至 ∞],P=0.004;S2:9.3%[1.7 至 ∞],P=0.009),而低密度脂蛋白胆固醇仅在 S2 组降低(-11.0%[-∞至-3.5],P=0.002)。S2 组中,GFT505 并未降低 2 小时血糖(-0.52mmol/L[-∞至 0.61],P=0.18),但可显著降低稳态模型评估的胰岛素抵抗(-31.4%[-∞至 12.5],P=0.001)、空腹血糖(-0.37mmol/L[-∞至-0.10],P=0.01)和果糖胺(-3.6%[-∞至-0.20],P=0.02)。GFT505 还可降低两项研究中的γ-谷氨酰转移酶水平(S1:-19.9%[-∞至-12.8],P<0.0001;S2:-15.1%[-∞至-1.1],P=0.004)。研究期间未报告任何特定的不良安全信号。

结论

GFT505 可被视为一种治疗代谢综合征相关血脂和血糖紊乱的新型候选药物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8caa/3161281/e1bc5bbc8cf8/2008fig1.jpg

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