Clinical Trials Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Nov 15, 2020; 11(11): 514-526
Published online Nov 15, 2020. doi: 10.4239/wjd.v11.i11.514
Factors associated with improvement in waist-to-height ratio among newly diagnosed type 2 diabetes patients treated with acarbose or metformin: A randomized clinical trial study
Lu-Lu Song, Xin Wang, Zhao-Jun Yang, Xiao-Mu Kong, Xiao-Ping Chen, Bo Zhang, Wen-Ying Yang
Lu-Lu Song, Xin Wang, Zhao-Jun Yang, Xiao-Mu Kong, Xiao-Ping Chen, Bo Zhang, Wen-Ying Yang, Department of Endocrinology, China-Japan Friendship Hospital, Beijing 100029, China
Author contributions: Yang WY was the principal investigator of the trial; Song LL drafted the manuscript; Wang X was the co-investigator; Yang ZJ developed design of the trial; Kong XM provided important advice and guidance regarding the statistical analysis; and Chen XP and Zhang B contributed to the trial.
Institutional review board statement: The study was reviewed and approved by the China-Japan Friendship Hospital Institutional Review Board
Clinical trial registration statement: This study is registered at Chinese Clinical Trial Registry Center. The registration number is ChiCTR-TRC-08000231.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors have nothing to disclose.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Wen-Ying Yang, MD, Professor, Department of Endocrinology, China-Japan Friendship Hospital, No. 2 Yinghua East Street, Chaoyang District, Beijing 100029, China. yangwenying@zryhyy.com.cn
Received: June 28, 2020
Peer-review started: June 28, 2020
First decision: July 30, 2020
Revised: August 13, 2020
Accepted: September 14, 2020
Article in press: September 14, 2020
Published online: November 15, 2020
ARTICLE HIGHLIGHTS
Research background

Many type 2 diabetes mellitus (T2DM) patients are characterized by abdominal obesity, which is associated with a high risk of cardiovascular diseases and mortality. The waist-to-height ratio (WHtR) reflects abdominal obesity and is a promising measure for the evaluation of cardiovascular risk. The metformin and acarbose in Chinese as the initial Hypoglycaemic treatment trial demonstrated that acarbose and metformin reduced the WHtR after 24 wk of treatment. The factors associated with the reduction in the WHtR after monotherapy of acarbose or metformin are unclear.

Research motivation

We attempted to investigate whether the factors associated with the WHtR reduction after the acarbose or metformin treatment differ in newly diagnosed T2DM. We also attempted to clarify the role of glucagon-like peptide 1 (GLP-1) in reducing the WHtR under treatment with two classical oral antidiabetic drugs.

Research objectives

We aimed to identify the factors associated with WHtR reduction after 24 wk within the acarbose and metformin groups.

Research methods

Logistic regression analyses were performed using SPSS statistical software (version 25.0). Further stratified analysis was performed to investigate the associations between GLP-1 and WHtR reduction under acarbose or metformin treatment.

Research results

In this study, we found a sex difference in WHtR reduction in both the acarbose and metformin treatments. An increase in the area under the curve of GLP-1was associated with a high ΔWHtR in the acarbose group. We also identified that a higher reduction in high-density lipoprotein cholesterol/non-high-density lipoprotein cholesterol was associated with a high ΔWHtR in the acarbose arm, while a higher reduction in fasting plasma glucose and total cholesterol was associated with a high ΔWHtR in the metformin group.

Research conclusions

Our study showed that the baseline GLP-1 level and increase in GLP-1 level are associated with WHtR reduction under acarbose treatment in newly diagnosed T2DM. Additionally, in the low baseline area under the curve of GLP-1 group, the acarbose treatment could lead to a greater decrease in the WHtR than metformin.

Research perspectives

This study could provide new evidence for oral antidiabetic drug selection in newly diagnosed Chinese T2DM.