Efficacy of Xiaokeqing granules and lifestyle intervention in treating prediabetes mellitus considering metabolomic biomarkers: A randomised controlled trial.

IF 4.6 3区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Jin-Dong Zhao, Meng-Zhu Guo, Yi Zhang, Shao-Hua Zhu, Ya-Ting Wang, Yan-Ping Zhang, Xin Liu, Si Cheng, Fei Wang, Qi Xu, Nuo-Bing Ruan, Zhao-Hui Fang
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引用次数: 0

Abstract

Background: Prediabetes mellitus (PDM) is receiving increasing attention as a precursor to type 2 diabetes mellitus. Lifestyle and traditional Chinese medicine (TCM) interventions are effective for PDM prevention and treatment. Therefore, we conducted a preliminary investigation and an exploratory randomised controlled trial to assess the effects of a combined lifestyle and TCM intervention on PDM indicators.

Aim: To study the effectiveness of Xiaokeqing granules (XQG) and lifestyle interventions in PDM participants while using metabolomics to identify potential markers.

Methods: Forty PDM participants with yin deficiency syndrome with excessive heat were recruited and randomly allocated to the control (Con) group or the XQG group (20 per group). The Con group underwent lifestyle interventions, whereas the XQG group underwent lifestyle and XQG interventions. The follow-up duration was 2 months. Fasting blood glucose, 2-hour postprandial glucose (2hPG), glycated haemoglobin A1c, fasting insulin, homeostasis model assessment-insulin resistance levels, and serum metabolomics characteristics were compared via liquid chromatography-tandem mass spectrometry analysis.

Results: There were significant differences in 2hPG between the two groups (P < 0.05) in the intention-to-treat analysis and per-protocol analysis. The intervention method used in this study was safe (P > 0.05). Groenlandicine, kaempferol, isomangiferin, etc., are the XQG constituents absorbed in the blood. N-Nervonoyl methionine and 5-hydroxy-L-tryptophan are core potential metabolomic biomarkers for the effectiveness of XQG and lifestyle interventions. HTR1A, HTR2C, SLC6A4, etc., are the core targets of XQG and lifestyle interventions, as well as the reason for their clinical efficacy. Possible mechanistic pathways include tryptophan metabolism, pantothenate and certificate of analysis biosynthesis, lysine degradation and biosynthesis of cofactors.

Conclusion: This pilot study provides evidence that a combined XQG and lifestyle intervention can improve 2hPG in participants with PDM. The mechanism of action is related to multiple constituents, targets and pathways.

消炎清颗粒和生活方式干预治疗糖尿病前期代谢组学生物标志物的疗效:一项随机对照试验。
背景:前驱糖尿病(PDM)作为2型糖尿病的前兆正受到越来越多的关注。生活方式和中医干预对PDM的预防和治疗是有效的。因此,我们进行了一项初步调查和一项探索性随机对照试验,以评估生活方式和中医药联合干预对PDM指标的影响。目的:研究消咳清颗粒(XQG)和生活方式干预在PDM患者中的有效性,同时利用代谢组学方法识别潜在的标志物。方法:招募40例阴虚热证PDM患者,随机分为对照组(Con)和XQG组(每组20例)。Con组接受生活方式干预,而XQG组接受生活方式和XQG干预。随访时间2个月。通过液相色谱-串联质谱分析比较空腹血糖、餐后2小时血糖(2hPG)、糖化血红蛋白A1c、空腹胰岛素、稳态模型评估-胰岛素抵抗水平和血清代谢组学特征。结果:两组患者2hPG在意向治疗分析和方案分析中差异均有统计学意义(P < 0.05)。本研究采用的干预方法是安全的(P < 0.05)。葛兰地黄、山奈酚、异马吉兰素等是XQG在血液中吸收的成分。n -神经酰蛋氨酸和5-羟基- l -色氨酸是XQG和生活方式干预有效性的核心潜在代谢组学生物标志物。HTR1A、HTR2C、SLC6A4等是XQG和生活方式干预的核心靶点,也是其临床疗效的原因。可能的机制途径包括色氨酸代谢,泛酸和分析证书的生物合成,赖氨酸降解和辅因子的生物合成。结论:本初步研究提供了XQG和生活方式联合干预可以改善PDM患者2hPG的证据。其作用机制涉及多种成分、靶点和途径。
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来源期刊
World Journal of Diabetes
World Journal of Diabetes ENDOCRINOLOGY & METABOLISM-
自引率
2.40%
发文量
909
期刊介绍: The WJD is a high-quality, peer reviewed, open-access journal. The primary task of WJD is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of diabetes. In order to promote productive academic communication, the peer review process for the WJD is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJD are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in diabetes. Scope: Diabetes Complications, Experimental Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 2 Diabetes Mellitus, Diabetes, Gestational, Diabetic Angiopathies, Diabetic Cardiomyopathies, Diabetic Coma, Diabetic Ketoacidosis, Diabetic Nephropathies, Diabetic Neuropathies, Donohue Syndrome, Fetal Macrosomia, and Prediabetic State.
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