ADOPT研究的最新结果

Late breaking results from the ADOPY study

在南非开普敦召开的国际糖尿病联盟（IDF）第19届世界糖尿病大会报道了糖尿病终点进展试验（ADOPT）的结果。该研究评估了未经治疗的新诊断2型糖尿病患者接受罗格列酮、二甲双胍或磺脲类单一药物治疗的长期血糖控制。经过平均4年的治疗，罗格列酮组、二甲双胍组及格列本脲组发生单药失效率分别为15％、21％和34％。与二甲双胍或格列本脲相比，罗格列酮能延缓单药失效的进展（P〈0．001），更能使糖化血红蛋白Alc水平维持在〈7％，改善胰岛素敏感性及β细胞功能。罗格列酮可引起体重增加、水肿。与格列本脲比较，罗格列酮的心血管事件（包括充血性心力衰竭）的发生率增多（P〈0．05），但独立评价的充血性心力衰竭的结果相近。ADOPT研究结果为罗格列酮延缓进行性高血糖优于二甲双胍或格列本脲提供了依据。

A Diabetes Outcome Progression Trial （ADOPT） was presented at the International Diabetes Federation 19^th Annual World Congress in Cape Town. The study was to evaluate long-term glucose control via monotherapy with rosiglitazone, metformin, or sulfonylurea in treatment-naive patients with newly-diagnosed type 2 diabetes. Over median treatment duration of 4 years, the cumulative incidence of monotherapy failure was 15% with rosiglitazone, 21% with metformin, and 34% with glyburide. Compared to mefformin or glyburide, rosiglitazone slowed progression of monotherapy failure （ P 〈 0.001）, more effectively maintained Alc levels 〈 7%, improved insulin sensitivity and beta cell function. Rosiglitazone was associated with increased weight gain and edema. And rosiglitazone had more cardiovascular events [ including congestive heart failure （CHF） ] than glyburide （ P 〈 0.05）, but similar rates of CHF from independent review. These results provide evidence that rosiglitazone can slow progression to hyperglycemia to a greater extent than mefformin or glyburide monotherapy.