Magkos Faidon, Nikonova Elena, Fain Randi, Zhou Sharon, Ma Tony, Shanahan William
Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore & Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore.
Eisai Medical and Scientific Affairs, Eisai Inc, Woodcliff Lake, New Jersey, USA.
Obesity (Silver Spring). 2017 May;25(5):842-849. doi: 10.1002/oby.21798. Epub 2017 Mar 27.
Lorcaserin, a 5-HT receptor agonist approved for chronic weight management, is also associated with improvements in glycemic parameters in patients with/without type 2 diabetes mellitus (T2DM), but the extent to which these effects are mediated by weight loss is unknown. This post hoc analysis further examines glycemic data from the Phase III BLOOM-DM study stratified by weight changes.
Patients with T2DM were randomized to lorcaserin 10 mg twice daily or placebo. Glycemic parameters were reported by Week (W) 12 weight loss status ≥5% (Group ≥5%) or <5% (Group <5%). Glycemic parameter changes were analyzed using ANCOVA; the relationship between glycemic parameter changes and percent weight loss was assessed by simple regression modeling.
Group ≥5% receiving lorcaserin had greater improvements in fasting plasma glucose (FPG) at W2 (prior to significant weight loss) and greater improvements in glycated hemoglobin (HbA1c) at W12 versus placebo. These improvements were maintained through W52 (FPG, -29.3 mg/dL vs. -24.2 mg/dL; HbA1c, -1.2% vs. -1.1%). Group <5% treated with lorcaserin also had larger decreases in FPG (-28.3 mg/dL vs. -10.0 mg/dL) and HbA1c (-0.8% vs. -0.4%) at W52 versus placebo despite limited weight loss.
Lorcaserin may have beneficial effects on glycemic control with or without weight loss.
氯卡色林是一种被批准用于慢性体重管理的5-羟色胺受体激动剂，在2型糖尿病（T2DM）患者和非T2DM患者中均可改善血糖参数，但这些作用通过体重减轻介导的程度尚不清楚。本事后分析进一步检查了III期BLOOM-DM研究中按体重变化分层的血糖数据。
T2DM患者被随机分为每日两次服用10mg氯卡色林或安慰剂。在第12周时，根据体重减轻状态≥5%（≥5%组）或<5%（<5%组）报告血糖参数。使用协方差分析（ANCOVA）分析血糖参数变化；通过简单回归模型评估血糖参数变化与体重减轻百分比之间的关系。
与安慰剂相比，≥5%组接受氯卡色林治疗的患者在第2周时空腹血糖（FPG）改善更大（在显著体重减轻之前），在第12周时糖化血红蛋白（HbA1c）改善更大（FPG，-29.3mg/dL对-24.2mg/dL；HbA1c，-1.2%对-1.1%）。这些改善一直维持到第52周。尽管体重减轻有限，但<5%组接受氯卡色林治疗的患者在第52周时FPG（-28.3mg/dL对-10.0mg/dL）和HbA1c（-0.8%对-0.4%）的下降幅度也比安慰剂组更大（FPG为-28.3mg/dL对-10.0mg/dL；HbA1c为-0.8%对-0.4%）。
无论体重是否减轻，氯卡色林可能对血糖控制有益。
