二甲双胍使用者与胰岛素使用者的代谢特征及其心血管事件风险的比较一项来自英国生物银行的2型糖尿病患者队列研究

IF 6.1 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice Pub Date : 2025-03-21 DOI:10.1016/j.diabres.2025.112108

Li-Ju Chen , Christian Herder , Ruijie Xie , Hermann Brenner , Ben Schöttker

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引用次数: 0

摘要

目的比较单用二甲双胍和胰岛素治疗的2型糖尿病患者的代谢特征，评估单用二甲双胍和单用胰岛素治疗的2型糖尿病患者的代谢产物与主要心血管不良事件（MACE）的相关性，并检验降糖治疗是否会改变疗效。方法我们纳入了来自英国生物样本库的3058名二甲双胍使用者和558名胰岛素使用者。将二甲双胍和胰岛素使用者的249种代谢物的平均浓度与Cohen’s d进行比较，用Cox回归评估它们与MACE的相关性，并检验相互作用项。结果仅胰岛素和仅二甲双胍使用者的平均VLDL大小、HDL大小、大分子和超大分子HDL浓度存在差异。总体而言，75个代谢组学生物标志物与仅胰岛素使用者的MACE显著相关，57个与仅二甲双胍使用者的MACE显著相关。治疗组与白蛋白（仅在二甲双胍使用者中具有保护作用）和86种脂质/脂肪酸之间观察到显著的相互作用项，仅在胰岛素使用者中均与MACE有统计学显著相关。结论二甲双胍使用者与胰岛素使用者具有不同的代谢特征，二甲双胍使用者的代谢特征优于胰岛素使用者，其相关的MACE风险较低。

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Comparison of the metabolic profiles and their cardiovascular event risks of metformin users versus insulin users. A cohort study of people with type 2 diabetes from the UK Biobank

Aim

The aims of this study were to compare the metabolic profiles of type 2 diabetes mellitus patients with metformin and insulin monotherapy, to assess the associations of metabolites with major adverse cardiovascular events (MACE) distinctly for metformin-only and insulin-only users, and to test for effect modification by the glucose-lowering treatment.

Methods

We included 3,058 metformin-only and 558 insulin-only users from the UK Biobank. Mean concentrations of 249 metabolites of metformin and insulin users were compared with Cohen’s d, their associations with MACE were assessed with Cox regression and interaction terms were tested.

Results

Mean VLDL size, HDL size, and concentrations of large and very large HDL molecules differed between insulin-only and metformin-only users. Overall, 75 metabolomic biomarkers were significantly associated with MACE in insulin-only users and 57 in metformin-only users. Significant interaction terms were observed between treatment group and albumin (protective in metformin users only) and 86 lipids/fatty acids, which were all statistically significantly associated with MACE among insulin users only.

Conclusion

Metformin and insulin users have different metabolic profiles and a consistent pattern emerged that the metabolic profile of metformin users is favorable compared to the one of insulin users due to a lower associated MACE risk.

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来源期刊

Diabetes research and clinical practice 医学-内分泌学与代谢

CiteScore

10.30

自引率

3.90%

发文量

862

审稿时长

32 days

期刊介绍： Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.