Department of Transplantation Medicine, Institute of Clinical Medicine, University of Oslo and Oslo University Hospital, Oslo, Norway.
Department of Endocrinology, St. Olav's Hospital, Trondheim, Norway.
Diabetes Obes Metab. 2019 Feb;21(2):429-433. doi: 10.1111/dom.13528. Epub 2018 Oct 3.
We compared cardiovascular and other outcomes in patients with dysglycaemia with or without anti-glutamic acid dehydrogenase (GAD) antibodies participating in the Outcome Reduction with Initial Glargine Intervention (ORIGIN) trial. Of the 12 537 participants, 8162 had anti-GAD measured at baseline and 267 were anti-GAD positive. The effects of insulin glargine versus standard care and of n-3 fatty acids supplements versus placebo were compared by testing the interaction of the treatment effects and anti-GAD status. The effect of glargine on development of new diabetes was assessed in participants without previous diabetes at baseline. The overall incidence of outcomes did not differ between anti-GAD positive and anti-GAD negative subjects. The incidence of the composite of cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke did not differ between anti-GAD positive participants randomized to insulin glargine or to standard care, with a hazard ratio (HR) (95% confidence interval [CI]) of 0.80 (0.44-1.44) or in anti-GAD negative participants with a HR of 1.07 (0.96-1.20) (P for interaction = 0.20).
我们比较了伴有或不伴有谷氨酸脱羧酶（GAD）抗体的糖基化异常患者在参加 OUTCOME 减少的初始甘精胰岛素干预（ORIGIN）试验中的心血管和其他结局。在 12537 名参与者中，8162 名在基线时测量了抗 GAD，267 名抗 GAD 阳性。通过检验治疗效果和抗 GAD 状态的相互作用，比较了甘精胰岛素与标准治疗的效果和 n-3 脂肪酸补充剂与安慰剂的效果。在基线时没有既往糖尿病的参与者中，评估了甘精胰岛素对新发糖尿病的影响。抗 GAD 阳性和抗 GAD 阴性患者的总体结局发生率没有差异。抗 GAD 阳性的参与者随机分配到甘精胰岛素或标准治疗，心血管死亡、非致死性心肌梗死或非致死性卒中的复合发生率无差异，风险比（HR）（95%置信区间[CI]）为 0.80（0.44-1.44），抗 GAD 阴性的参与者 HR 为 1.07（0.96-1.20）（P 交互=0.20）。
