Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang, 110001, China.
The Third People's Hospital of Dalian (Dalian Third People's Hospital Affiliated to Dalian Medical University), Dalian, 116000, China.
Endocr J. 2021 Jan 28;68(1):69-79. doi: 10.1507/endocrj.EJ20-0006. Epub 2020 Sep 10.
Using the data from the trial of Metformin and AcaRbose in Chinese as the initial Hypoglycemic treatment (MARCH), this study was performed to compare the differential effects of acarbose and metformin on glucose metabolism after stratification by gender. Six hundred and forty patients who had finished the whole 48-week follow-up were included. The reduction of haemoglobin A1c (HbA) was comparable between acarbose- and metformin-treated patients among either females or males, and it was also similar between males and females treated with either acarbose or metformin for 24 and 48 weeks. The dropping of fasting plasma glucose (FPG) in acarbose-treated females was significantly less than that in metformin-treated females at both 24 and 48 weeks. Furthermore, the decrease of 2-hour postprandial glucose (2hPPG) in acarbose-treated males was significantly greater than that in metformin-treated males at both 24 and 48 weeks. Multiple linear regression analysis showed that drug selection was an independent factor affecting the decrease of FPG in female patients while it independently influenced 2hPPG in males at week 24 and 48. The reductions of FPG and 2hPPG at week 24 and 48 were also significantly different between metformin-treated females and metformin-treated males although gender was not an independent regulating factor. Our study indicates that there might be gender-differential effects on FPG and 2hPPG reduction when the comparisons are made between acarbose and metformin treatments.
本研究使用二甲双胍和阿卡波糖治疗中国糖尿病（MARCH）试验的数据，按性别分层比较阿卡波糖和二甲双胍对葡萄糖代谢的差异影响。共纳入 644 例完成全部 48 周随访的患者。女性和男性中，阿卡波糖组和二甲双胍组患者的血红蛋白 A1c（HbA）降低幅度相当，且两组患者在 24 和 48 周时分别接受阿卡波糖和二甲双胍治疗时，HbA 降低幅度也相似。阿卡波糖治疗女性患者的空腹血糖（FPG）下降幅度在 24 和 48 周时均显著低于二甲双胍治疗女性患者。此外，阿卡波糖治疗男性患者的餐后 2 小时血糖（2hPPG）下降幅度在 24 和 48 周时均显著大于二甲双胍治疗男性患者。多线性回归分析显示，药物选择是影响女性患者 FPG 降低的独立因素，而在 24 和 48 周时，药物选择独立影响男性患者 2hPPG。尽管性别不是独立的调节因素，但二甲双胍治疗女性和男性患者在第 24 和 48 周时的 FPG 和 2hPPG 降低幅度也存在显著差异。我们的研究表明，在阿卡波糖和二甲双胍治疗之间进行比较时，可能存在对 FPG 和 2hPPG 降低的性别差异效应。
