期刊
DIABETES
卷 62, 期 11, 页码 3920-3926出版社
AMER DIABETES ASSOC
DOI: 10.2337/db13-0265
关键词
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资金
- National Institutes of Health General Clinical Research Center [MO1-RR00221]
- University of Tennessee Health Science Center
- National Institutes of Health Clinical and Translational Science Award [UL1TR000130]
- University of Southern California
- South Texas Veterans Health Care System-Audie Murphy Division.
- Takeda
- Phoenix Data Coordinating Center by means of a grant from Takeda
- Merck
- Allergan
- Amylin
- Roche
- Eli Lilly
- Sanofi
- Medtronics
- BMS
- Novo Nordisk
- Janssen
- Boehringer Ingelheim
- HDL Diagnostics Inc
- Bureau of Takeda
- Tethys Bioscience
- Gilead
- Intarcia
- Isis
- AstraZeneca
- Daiichi Sankyo
- Elcelyx
We examined the metabolic characteristics that attend the development of type 2 diabetes (T2DM) in 441 impaired glucose tolerance (IGT) subjects who participated in the ACT NOW Study and had complete end-of-study metabolic measurements. Subjects were randomized to receive pioglitazone (PGZ; 45 mg/day) or placebo and were observed for a median of 2.4 years. Indices of insulin sensitivity (Matsuda index [MI]), insulin secretion (IS)/insulin resistance (IR; I0-120/G(0-120,) IS rate [ISR](0-120)/G(0-120)), and -cell function (I/G x MI and ISR/G x MI) were calculated from plasma glucose, insulin, and C-peptide concentrations during oral glucose tolerance tests at baseline and study end. Diabetes developed in 45 placebo-treated vs. 15 PGZ-treated subjects (odds ratio [OR] 0.28 [95% CI 0.15-0.49]; P < 0.0001); 48% of PGZ-treated subjects reverted to normal glucose tolerance (NGT) versus 28% of placebo-treated subjects (P < 0.005). Higher final glucose tolerance status (NGT > IGT > T2DM) was associated with improvements in insulin sensitivity (OR 0.61 [95% CI 0.54-0.80]), IS (OR 0.61 [95% CI 0.50-0.75]), and -cell function (ln IS/IR index and ln ISR/IR index) (OR 0.26 [95% CI 0.19-0.37]; all P < 0.0001). Of the factors measured, improved -cell function was most closely associated with final glucose tolerance status.
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