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Diabetologia:每周一次的半胱氨酸与每日一次的卡那格列汀对2型糖尿病患者身体成分的影响?

2020-04-12 MedSci原创 MedSci原创

腹腔内或内脏肥胖与胰岛素抵抗和心血管疾病风险增加有关。本研究旨在比较semaglutide 1.0 mg和canagliflozin 300 mg对持续8期IIIB患者的身体组成的影响。

腹腔内或内脏肥胖与胰岛素抵抗和心血管疾病风险增加有关。本研究旨在比较semaglutide 1.0 mg和canagliflozin 300 mg对持续8期IIIB患者的身体组成的影响。

研究人员将患有2型糖尿病成人(年龄≥18岁),HbA1c 53–91 mmol / mol(7.0–10.5%),每日稳定剂量的二甲双胍(≥1500mg或最大耐受剂量)且eGFR≥60ml min -1 [1.73 m] -2按1:1比例随机分配至semaglutide 1.0 mg每周一次和canagliflozin安慰剂一次,或canagliflozin 300 mg每天一次和semaglutide安慰剂一次。 使用全身DXA扫描评估身体成分。 在整个试验过程中,研究参与者和研究者都保持盲法,并且以盲法评估DXA扫描的质量。从基线到第52周总脂肪量(kg)的变化是确认疗效的终点。

178名参与者中的一个子集(semaglutide,n = 88;canagliflozin,n = 90)在筛查时接受了DXA扫描,并被随机纳入亚研究。其中,114名参与者(semaglutide,n = 53;canagliflozin,n = 61)在治疗结束时观察到的数据被纳入疗效确认分析。在178名参与亚研究的参与者中,52周后观察到两种治疗的身体成分(包括脂肪质量、瘦肉质量和内脏脂肪质量)的数值改善。使用semaglutide和canagliflozin,总脂肪质量(基线33.2 kg)分别减少了3.4 kg和2.6 kg(估计治疗差异:-0.79 [95% CI-2.10,0.51])。虽然用semaglutide和canagliflozin的总瘦肉质量(基线51.3kg)也分别减少了2.3kg和1.5kg(估计治疗差异:-0.78[-1.61,0.04]),但瘦肉质量(基线59.4%)的比例分别增加了1.2%-和1.1%-点(估计治疗差异0.14[-0.89,1.17])。两组治疗组内脏脂肪质量的变化和身体成分的总体变化(通过脂肪与瘦肉质量比值评估)具有可比性。

在接受稳定剂量二甲双胍治疗的2型糖尿病患者中,semaglutide和canagliflozin对机体组成的影响无显著差异。虽然在两个治疗组的治疗后都观察到身体成分的改善,但在没有安慰剂组的情况下,两种治疗对身体成分的具体影响在这个阶段目前是推测性的。

原始出处:

Rory J. McCrimmon, Andrei-Mircea Catarig,Effects of once-weekly semaglutide vs once-daily canagliflozin on body composition in type 2 diabetes: a substudy of the SUSTAIN 8 randomised controlled clinical trial

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    2020-04-12 misszhang

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