Associations between changes in glucagon‐like peptide‐1 and bodyweight reduction in patients receiving acarbose or metformin treatment

Background The present post hoc analysis investigated whether changes in endogenous glucagon‐like peptide‐1 (∆GLP‐1) levels are associated with weight loss in newly diagnosed diabetes patients. Methods In all, 784 subjects from the Metformin and AcaRbose in Chinese as initial Hypoglycemic treatment (MARCH) study were stratified according to ∆GLP‐1. Changes in clinical and physiological parameters were evaluated across ∆GLP‐1 subgroups (low, medium, and high) to assess correlations between ∆GLP‐1 and weight loss in acarbose‐ versus metformin‐treated groups. Results After 24 weeks treatment, greater ∆GLP‐1 was associated with significantly greater weight loss (−2 vs −1 kg in the medium/high vs low ∆GLP‐1 groups, respectively) and reduction in body mass index (BMI; −0.88, −0.83, and −0.69 kg/m2 in the high, medium, and low ∆GLP‐1 groups, respectively). In the acarbose‐treated group, there was a significant association between ∆GLP‐1 and BMI reductions, and greater ∆GLP‐1 across the high, medium, and low ∆GLP‐1 groups was correlated with greater weight loss (−2.8, −2.1, and −1.9 kg, respectively) and reductions in fasting plasma glucose (−1.57, −1.28, and −1.02 mmol/L, respectively) at Week 24. No significant differences were found across ∆GLP‐1 subgroups in metformin‐treated patients (P > 0.05). Multivariate linear regression analysis revealed that gender, baseline BMI, and ∆GLP‐1 at Week 24 were associated with weight loss. Baseline BMI and ∆GLP‐1 in the acarbose‐treated group and baseline BMI in the metformin‐treated group predicted weight loss at Week 24. Conclusion Changes in GLP‐1 levels are associated with weight loss in newly diagnosed Chinese diabetes patients receiving acarbose. 背景 本研究为一项事后分析,探讨内源性GLP‐1水平的改变(ΔGLP‐1)与新诊断的2型糖尿病患者体重下降之间的关系。 方法 根据MARCH研究(Metformin and AcaRbose in Chinese as initial Hypoglycemic treatment study)中784例患者GLP‐1的变化将其分为ΔGLP‐1低值组、ΔGLP‐1中值组和ΔGLP‐1高值组。评估三个亚组患者的临床与生理参数的变化以分析在二甲双胍和阿卡波糖治疗组中ΔGLP‐1水平与患者体重变化之间的关系。 结果 新诊断患者降糖药物治疗24周后,ΔGLP‐1水平越高,体重下降越显著(−2kg [ΔGLP‐1中值和高值组] vs −1kg [ΔGLP‐1低值组]),BMI降低越显著([BMI分别为:−0.88 kg/m2 [ΔGLP‐1高值组]、−0.83 kg/m2 [ΔGLP‐1中值组]和−0.69 kg/m2(ΔGLP‐1低值组])。在接受阿卡波糖治疗24周后,患者的高ΔGLP‐1与BMI下降显著相关,ΔGLP‐1高值组、ΔGLP‐1中值组、ΔGLP‐1低值组中更高的ΔGLP‐1水平与更多的体重下降(体重变化分别为‐2.8 kg、‐2.1 kg、‐1.9 kg)和空腹血糖水平下降相关(空腹血糖变化分别为‐1.57、−1.28、−1.02 mmol/L)。在接受二甲双胍治疗的患者中未发现ΔGLP‐1与体重下降相关。多因素分析显示总体人群的性别、基线BMI以及24周时的ΔGLP‐1与体重下降相关。阿卡波糖组的基线BMI和ΔGLP‐1,二甲双胍组的基线BMI可预测24周时的体重下降。 结论 接受阿卡波糖治疗的新诊断的2型糖尿病患者, 其体重降低与ΔGLP‐1水平相关。 Multivariate linear regression analysis of