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在 2 型糖尿病中,双重 PPARα/γ激动剂对餐后甘油三酯的消除作用:一项随机、安慰剂对照研究。

Abrogation of postprandial triglyceridemia with dual PPAR α/γ agonist in type 2 diabetes mellitus: a randomized, placebo-controlled study.

机构信息

Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.

Cardiometabolic and Lipid Clinic, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA.

出版信息

Acta Diabetol. 2020 Jul;57(7):809-818. doi: 10.1007/s00592-020-01487-8. Epub 2020 Feb 6.

Abstract

AIMS

Lowering postprandial lipemia may mitigate cardiovascular risk in patients with diabetic dyslipidemia. This study was aimed to investigate whether saroglitazar suppresses postprandial lipemia in patients with diabetes and dyslipidemia.

METHODS

This was a 12-week, prospective, multicenter, randomized, double-blinded, placebo-controlled study of saroglitazar in patients with diabetes and dyslipidemia. Thirty patients were randomized (1:1) to receive saroglitazar 4 mg or placebo orally once daily with metformin for 12 weeks. The primary endpoint was change in plasma triglyceride (TG) area under the curve (AUC) on a standardized 8-h fat tolerance test.

RESULTS

Thirty participants were randomized for interventions and eventually data of 19 participants qualified for per protocol analyses. Mean (SD) age in saroglitazar was 53.1 (8.8) years and 54.9 (7.7) years in placebo group. After 12 weeks, saroglitazar significantly lowered postprandial TG-AUC by - 458.3 (144.0) (- 25.7%, 95% CI - 765.1 to - 151.4) versus an increase of + 10.9 (157.9) (+ 0.5%, 95% CI - 325.6 to 347.3) mg/dL h in placebo group (P < 0.05). Saroglitazar lowered postprandial TG incremental AUC versus placebo: - 329.4 (89.9) (- 59%) versus + 80.4 (99.4) (+ 10%) mg/dL h (P < 0.05). HbA1c (%) decreased by - 0.36 (0.42) in the saroglitazar group as compared to an increase of + 1.26 (0.46) (P < 0.05) with placebo.

CONCLUSIONS

The saroglitazar treatment significantly improved postprandial TGs in people with diabetic dyslipidemia.

TRIAL REGISTRATION

Clinical Trial Registry of India; trial Registration No.: CTRI/2015/06/005845 and Date of registration: June 02, 2015.

摘要

目的

降低餐后血脂可降低糖尿病血脂异常患者的心血管风险。本研究旨在探讨沙格列汀是否能抑制糖尿病血脂异常患者的餐后血脂。

方法

这是一项为期 12 周、前瞻性、多中心、随机、双盲、安慰剂对照的沙格列汀在糖尿病伴血脂异常患者中的研究。30 名患者按 1:1 随机接受沙格列汀 4mg 或安慰剂,每日 1 次,与二甲双胍合用 12 周。主要终点是标准化 8 小时脂肪耐量试验时血浆甘油三酯(TG)曲线下面积(AUC)的变化。

结果

30 名参与者被随机分组进行干预,最终有 19 名参与者的数据符合方案分析。沙格列汀组平均(SD)年龄为 53.1(8.8)岁,安慰剂组为 54.9(7.7)岁。12 周后,沙格列汀可显著降低餐后 TG-AUC 达-458.3(144.0)(-25.7%,95%CI-765.1 至-151.4),而安慰剂组则增加 10.9(157.9)(0.5%,95%CI-325.6 至 347.3)mg/dL·h(P<0.05)。沙格列汀降低餐后 TG 增量 AUC 与安慰剂相比:-329.4(89.9)(-59%)与+80.4(99.4)(+10%)mg/dL·h(P<0.05)。与安慰剂组相比,沙格列汀组的 HbA1c(%)降低了-0.36(0.42),而安慰剂组则升高了+1.26(0.46)(P<0.05)。

结论

沙格列汀治疗可显著改善糖尿病血脂异常患者的餐后血脂。

临床试验注册

印度临床试验注册处;试验注册号:CTRI/2015/06/005845 和注册日期:2015 年 6 月 2 日。

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