Esteghamati Alireza, Noshad Sina, Rabizadeh Soghra, Ghavami Mojgan, Zandieh Ali, Nakhjavani Manouchehr
Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Regul Pept. 2013 Mar 10;182:1-6. doi: 10.1016/j.regpep.2012.12.005. Epub 2013 Jan 14.
To assess the effects of two commonly used oral hypoglycemic medications metformin and pioglitazone on serum concentrations of omentin and leptin in patients with newly diagnosed type 2 diabetes.
In a clinical trial setting (NCT01593371), patients were randomly allocated to either metformin 1000mg daily (n=41), or pioglitazone 30mg daily (n=50). Serum concentrations of omentin and leptin were measured at baseline and after 12weeks. Patients' weight, waist circumference, blood pressure, fasting plasma glucose, fasting insulin, HbA1c, highly sensitive C-reactive protein, and serum lipids were also measured at the two visits.
Baseline concentrations of omentin and leptin were not different between the two arms of the trial. After three months, metformin decreased both omentin and leptin concentrations in women, and leptin concentrations only in men. On the other hand, pioglitazone reduced both adipokines only in women, but not men. Univariate and multivariate ANCOVA models revealed that both interventions are equally effective in reducing omentin concentration (p=0.497 for women and 0.344 for men in multivariate models controlling for the effects of confounding variables). Similarly, neither medication was more effective in reducing leptin concentrations after three months (p=0.822 for women and 0.441 for men in multivariate models).
Metformin and pioglitazone at pharmacologic doses are equally effective in alteration of serum omentin and leptin concentrations in patients with diabetes, albeit sex differences in response to medications exist. Implication of these findings on long term management and complication prevention of diabetes needs to be elucidated.
评估两种常用口服降糖药物二甲双胍和吡格列酮对新诊断2型糖尿病患者血清网膜素和瘦素浓度的影响。
在一项临床试验（NCT01593371）中，患者被随机分为两组，一组每日服用1000mg二甲双胍（n = 41），另一组每日服用30mg吡格列酮（n = 50）。在基线和12周后测量血清网膜素和瘦素浓度。在两次就诊时还测量了患者的体重、腰围、血压、空腹血糖、空腹胰岛素、糖化血红蛋白、高敏C反应蛋白和血脂。
试验的两组患者基线时网膜素和瘦素浓度无差异。三个月后，二甲双胍降低了女性的网膜素和瘦素浓度，仅降低了男性的瘦素浓度。另一方面，吡格列酮仅降低了女性的两种脂肪因子浓度，对男性无此作用。单因素和多因素协方差分析模型显示，两种干预措施在降低网膜素浓度方面同样有效（在控制混杂变量影响的多因素模型中，女性p = 0.497，男性p = 0.344）。同样，三个月后两种药物在降低瘦素浓度方面均未显示出更显著的效果（在多因素模型中，女性p = 0.822，男性p = 0.441）。
药理剂量的二甲双胍和吡格列酮在改变糖尿病患者血清网膜素和瘦素浓度方面同样有效，尽管药物反应存在性别差异。这些发现对糖尿病长期管理和并发症预防的意义有待阐明。
