Shao Cong, Lü Xiao-feng, Xiao Xin-hua, Xu Zhang-rong, Yang Zhao-jun, Wang Peng, Liu Xue-li, Yang Wen-ying
Graduate School of Peking Union Medical College, Beijing 100730, China.
Zhonghua Yi Xue Za Zhi. 2012 Jun 12;92(22):1522-6.
To explore the efficacy and influencing factors of chromium picolinate (tianmaixiaoke tablet) in the treatment of newly diagnosed type 2 diabetes mellitus in China.
A total of 84 outpatients with newly diagnosed type 2 diabetes mellitus visiting 4 hospitals in Beijing were randomly divided into two equal groups: study group receiving tianmaixiaoke tablet 240 mg bid for 24 weeks (n = 42) and control group sitagliptin 100 mg qd for 24 weeks (n = 42). The levels of fasting plasma glucose (FPG), plasma glucose 2 h after meal (PG2 h) and glycated hemoglobin (HbA1c) were detected before and 24 weeks after treatment. The serum levels of chromium and insulin were detected.
Study was completed in 76 patients. The serum level of chromium was significantly lower in the diabetes group than in the normal group at baseline ((56 ± 28) µg/L vs (112 ± 21) µg/L, P = 0.00). At 24 weeks after treatment, the levels of HbA1c, FPG and PG2 h decreased while the serum level of chromium increased significantly in both groups. There were 11 patients with changed HbA1c from baseline (ΔHbA1c) ≥ 1% in the study group. At 24 weeks after treatment, HbA1c decreased by 1.61% (from 8.38% ± 0.72% to 6.77% ± 0.62%) and serum level of chromium increased by 35.14 µg/L in the ΔHbA1c ≥ 1% group with a low baseline serum level of chromium ((36.2 ± 18.0) µg/L). Both study group and control group were divided into three subgroups according to baseline serum level of chromium. ΔHbA1c reduced with the increase in baseline serum level of chromium in study group, while in control group, ΔHbA1c was unrelated with baseline serum level of chromium. At 24 weeks after treatment, insulin resistance index (HOMA-IR) reduced, β cell function index (HOMA-β) and insulinogenic index (IGI) increased in both groups. Multiple linear regression showed that the variables significantly associated with ΔHbA1c were baseline HbA1c and the baseline serum level of chromium.
Chromium is commonly deficient in the newly diagnosed type 2 diabetics in China. HbA1c decreases and serum chromium increases significantly after chromium supplementation in the patients with a low baseline serum level of chromium.
探讨吡啶甲酸铬（天麦消渴片）治疗中国新诊断2型糖尿病的疗效及影响因素。
选取北京4家医院的84例新诊断2型糖尿病门诊患者，随机分为两组，每组42例。研究组服用天麦消渴片240mg，每日2次，共24周；对照组服用西格列汀100mg，每日1次，共24周。分别于治疗前及治疗24周后检测空腹血糖（FPG）、餐后2小时血糖（PG2h）及糖化血红蛋白（HbA1c）水平，并检测血清铬和胰岛素水平。
76例患者完成研究。糖尿病组基线时血清铬水平显著低于正常组（（56±28）μg/L对（112±21）μg/L，P = 0.00）。治疗24周后，两组HbA1c、FPG及PG2h水平均下降，血清铬水平显著升高。研究组有11例患者HbA1c较基线变化（ΔHbA1c）≥1%。治疗24周后，ΔHbA1c≥1%且基线血清铬水平较低（（36.2±18.0）μg/L）的患者，HbA1c下降1.61%（从8.38%±0.72%降至6.77%±0.62%），血清铬水平升高35.14μg/L。研究组和对照组均根据基线血清铬水平分为三个亚组。研究组中，ΔHbA1c随基线血清铬水平升高而降低，而对照组中，ΔHbA1c与基线血清铬水平无关。治疗24周后，两组胰岛素抵抗指数（HOMA-IR）降低，β细胞功能指数（HOMA-β）和胰岛素生成指数（IGI）升高。多元线性回归显示，与ΔHbA1c显著相关的变量为基线HbA1c和基线血清铬水平。
中国新诊断的2型糖尿病患者普遍存在铬缺乏。基线血清铬水平较低的患者补充铬后，HbA1c显著下降，血清铬显著升高。
