Department of Geriatrics, Xijing Hospital of Air Force Medical University, No.127 West Changle Road, Xi'an, 710032, China.
Department of Pharmacy, Second People's Hospital of Shaanxi Province, No.3 Shangqin Road, Xi'an, 710068, China.
BMC Pharmacol Toxicol. 2022 Oct 18;23(1):79. doi: 10.1186/s40360-022-00621-2.
Acarbose is one of the optimal drugs for patients with the first diagnosis of type 2 diabetes mellitus (T2DM). But what kind of emerging patients has the best therapeutic response to acarbose therapy has never been reported. To this end, we investigated predictors of acarbose therapeutic efficacy in newly diagnosed T2DM patients in China.
A total of 346 T2DM patients received acarbose monotherapy for 48 weeks as part of participating in the Study of Acarbose in Newly Diagnosed Patients with T2DM in China (MARCH study) from November 2008 to June 2011. Change in glycated hemoglobin (ΔHbA1c) served as a dependent variable while different baseline variables including sex, age, disease duration, weight, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), HbA1c, fasting plasma glucose (FPG), 2-h postprandial blood glucose (2 h PG), fasting insulin (FINS), 2-h postprandial insulin (2 h INS), early insulin secretion index (IGI), homeostasis model assessment of insulin resistance index (HOMA-IR), homeostasis model assessment of beta cell function (HOMA-B), area under the curve (AUC) of glucagon, insulin and GLP-1 were assessed as independent predictors. Step-wise multiple linear regression was employed for statistical analysis.
The results suggested that independent predictors of ΔHbA1c at 12 weeks included baseline body weight (β = - 0.012, P = 0.006), DBP (β = 0.010, P = 0.047), FPG (β = 0.111, P = 0.005) and 2 h PG (β = 0.042, P = 0.043). Independent predictors of ΔHbA1c at 24 weeks included disease duration (β = 0.040, P = 0.019) and FPG (β = 0.117, P = 0.001). Finally, independent predictor of ΔHbA1c at 48 weeks was disease duration (β = 0.038, P = 0.046).
Acarbose may be more effective in newly diagnosed T2DM patients with low FPG, low 2 h PG and obesity. The earlier T2DM is diagnosed and continuously treated with acarbose, the better the response to therapy.
阿卡波糖是初诊 2 型糖尿病（T2DM）患者的最佳药物之一。但阿卡波糖治疗对哪些新出现的患者最有效，尚未有报道。为此，我们调查了中国初诊 T2DM 患者中阿卡波糖治疗疗效的预测因素。
2008 年 11 月至 2011 年 6 月，346 例 T2DM 患者接受阿卡波糖单药治疗 48 周，作为中国新诊断 T2DM 患者阿卡波糖治疗研究（MARCH 研究）的一部分。糖化血红蛋白（HbA1c）的变化作为因变量，而不同的基线变量，包括性别、年龄、病程、体重、体重指数（BMI）、收缩压（SBP）、舒张压（DBP）、HbA1c、空腹血糖（FPG）、餐后 2 小时血糖（2 h PG）、空腹胰岛素（FINS）、餐后 2 小时胰岛素（2 h INS）、早期胰岛素分泌指数（IGI）、胰岛素抵抗指数评估的稳态模型（HOMA-IR）、β 细胞功能的稳态模型评估（HOMA-B）、胰高血糖素、胰岛素和 GLP-1 的曲线下面积（AUC）被评估为独立预测因子。采用逐步多元线性回归进行统计分析。
结果表明，12 周时 HbA1c 的独立预测因子包括基线体重（β=-0.012，P=0.006）、DBP（β=0.010，P=0.047）、FPG（β=0.111，P=0.005）和 2 h PG（β=0.042，P=0.043）。24 周时 HbA1c 的独立预测因子包括病程（β=0.040，P=0.019）和 FPG（β=0.117，P=0.001）。最后，48 周时 HbA1c 的独立预测因子是病程（β=0.038，P=0.046）。
阿卡波糖可能对初诊 T2DM 患者中 FPG 低、2 h PG 低和肥胖的患者更有效。T2DM 越早诊断并持续接受阿卡波糖治疗，对治疗的反应越好。
