Degaga Abraham, Sirgu Sisay, Huri Hasniza Zaman, Sim Maw Shin, Kebede Tedla, Tegene Birhanemeskel, Loganadan Navin Kumar, Engidawork Ephrem, Shibeshi Workineh
Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Department of Clinical Pharmacy & Pharmacy Practice, Faculty of Pharmacy, University of Malaya, Kuala Lumpur, Malaysia.
Diabetes Metab Syndr Obes. 2023 Aug 23;16:2523-2535. doi: 10.2147/DMSO.S426632. eCollection 2023.
This study aimed to evaluate whether the M420del variants of (rs72552763) is associated with metformin treatment response in Ethiopian patients with type 2 diabetes mellitus (T2DM).
A prospective observational cohort study was conducted on 86 patients with T2DM who had been receiving metformin monotherapy for <1 year. Patients showing ≥0.5% reduction in HbA1c levels from baseline within 3 months and remained low for at least another 3 months were defined as responders while those patients with <0.5% reduction in HbA1c levels and/or those whom started a new class of glucose-lowering drug(s) because of unsatisfactory reduction were defined as non-responders. In addition, good glycemic control was observed when HbA1c ≤7.0%, and the above values were regarded as poor. Genotyping of rs72552763 SNP was performed using TaqMan Drug Metabolism Enzyme Genotyping Assay and its association with metformin response and glycemic control were assessed by measuring the change in HbA1c and fasting blood glucose levels using Chi-square, logistic regression and Mann-Whitney -test. Statistical significance was set at p <0.05.
The minor allele frequency of the rs72552763 SNP of was 9.3%. Metformin response was significantly higher in deletion_GAT (del_G) genotypes as compared to the wild-type GAT_GAT (G_G) genotypes. Furthermore, a significantly lower median treatment HbA1 level was found in del_G genotypes as compared to G_G genotypes. However, the association of rs72552763 with metformin response was not replicated at the allele level. In contrast, the minor del_allele was significantly associated with good glycemic control compared to the G_allele, though not replicated at del_G genotypes level.
This study demonstrated that metformin response was significantly higher in study participants with a heterozygous carrier of M420del variants of as compared to the wild-type G_G genotypes after 3 months of treatment.
本研究旨在评估(rs72552763)的M420del变异体是否与埃塞俄比亚2型糖尿病(T2DM)患者的二甲双胍治疗反应相关。
对86例接受二甲双胍单药治疗<1年的T2DM患者进行了一项前瞻性观察队列研究。在3个月内HbA1c水平较基线降低≥0.5%且至少在接下来的3个月内保持较低水平的患者被定义为反应者,而HbA1c水平降低<0.5%和/或因降糖效果不佳而开始使用新一类降糖药物的患者被定义为无反应者。此外,当HbA1c≤7.0%时观察到血糖控制良好,上述值被视为不佳。使用TaqMan药物代谢酶基因分型检测法对rs72552763 SNP进行基因分型,并通过卡方检验、逻辑回归和Mann-Whitney检验测量HbA1c和空腹血糖水平的变化,评估其与二甲双胍反应和血糖控制的相关性。设定统计学显著性为p<0.05。
rs72552763 SNP的次要等位基因频率为9.3%。与野生型GAT_GAT(G_G)基因型相比,缺失_GAT(del_G)基因型的二甲双胍反应显著更高。此外,与G_G基因型相比,del_G基因型的治疗后HbA1中位数水平显著更低。然而,rs72552763与二甲双胍反应的关联在等位基因水平未得到重复验证。相反,与G等位基因相比,次要的del_等位基因与良好的血糖控制显著相关,尽管在del_G基因型水平未得到重复验证。
本研究表明,治疗3个月后,与野生型G_G基因型相比,携带M420del变异体杂合子的研究参与者的二甲双胍反应显著更高。