Zeng Wotan, Guo Yali, Chen Peixian, Liu Zhike, Chen Dafang, Han Chunji
Department of Physiology and Pathophysiology, College of Medicine, Yanbian University, Yanji, Jilin Province, China.
Department of Endocrinology, Central Hospital of Shenzhen Guangming New District, Shenzhen, China.
J Diabetes Investig. 2016 Sep;7(5):764-8. doi: 10.1111/jdi.12486. Epub 2016 Mar 8.
AIMS/INTRODUCTION: The objective of the present study was to investigate the effects of CYP2C9*3 polymorphisms on the therapeutic response to gliclazide in type 2 diabetes patients.
A total of 746 incident type 2 diabetes patients were included in this study. After enrolment, patients went on 4-week gliclazide monotherapy. Fasting plasma glucose was measured before and after treatment. Hypoglycemia episodes and lifestyle information were collected by weekly follow up. Genotyping of rs1057910 was carried out using the single base primer extension method. The t-test, analysis of variance and chisquare-test were used to evaluate the effects of rs1057910 alleles on the therapeutic response to gliclazide.
After the therapy, fasting plasma glucose decreased significantly from 11.2 ± 2.7 mmol/L to 8.0 ± 2.2 mmol/L (P < 0.001). Patients with AC/CC genotypes of rs1057910 had a greater reduction of fasting plasma glucose (3.6 vs 3.0 mmol/L, P < 0.001; 31.4 vs 24.5%, P < 0.001) and a higher rate of treatment success (54.7 vs 37.5%, P < 0.001; 51.4 vs 32.3%, P < 0.001; 71.6 vs 48.3%, P < 0.001 for criterion 1, 2 and 3, respectively).
The present study showed that the polymorphism at rs1057910 significantly affected the therapeutic response of gliclazide in type 2 diabetes mellitus patients. The risk allele is associated with a greater decrease of fasting blood glucose and a higher rate of treatment success with gliclazide monotherapy.
目的/引言:本研究的目的是调查CYP2C9*3基因多态性对2型糖尿病患者格列齐特治疗反应的影响。
本研究共纳入746例初发2型糖尿病患者。入组后,患者接受为期4周的格列齐特单药治疗。治疗前后测量空腹血糖。通过每周随访收集低血糖发作情况和生活方式信息。采用单碱基引物延伸法对rs1057910进行基因分型。使用t检验、方差分析和卡方检验评估rs1057910等位基因对格列齐特治疗反应的影响。
治疗后,空腹血糖从11.2±2.7mmol/L显著降至8.0±2.2mmol/L(P<0.001)。rs1057910基因型为AC/CC的患者空腹血糖降低幅度更大(分别为3.6对3.0mmol/L,P<0.001;31.4%对24.5%,P<0.001),治疗成功率更高(标准1分别为54.7%对37.5%,P<0.001;标准2分别为51.4%对32.3%,P<0.001;标准3分别为71.6%对48.3%,P<0.001)。
本研究表明,rs1057910处的基因多态性显著影响2型糖尿病患者对格列齐特的治疗反应。风险等位基因与空腹血糖更大幅度降低以及格列齐特单药治疗更高的成功率相关。