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Adiponectin, Insulin Sensitivity, β-Cell Function, and Racial/Ethnic Disparity in Treatment Failure Rates in TODAY.
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- المؤلفون: Arslanian, Silva1 (AUTHOR); El Ghormli, Laure2 (AUTHOR); Bacha, Fida3 (AUTHOR); Caprio, Sonia4 (AUTHOR); Goland, Robin5 (AUTHOR); Haymond, Morey W3 (AUTHOR); Levitsky, Lynne6 (AUTHOR); Nadeau, Kristen J7 (AUTHOR); White, Neil H8 (AUTHOR); Willi, Steven M9 (AUTHOR); TODAY Study Group (CORPORATE AUTHOR)
- المصدر:
Diabetes Care. Nov2016, Vol. 39 Issue 11, pN.PAG-N.PAG. 1p.
- الموضوع:
- معلومة اضافية
- نبذة مختصرة :
Objective: The Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) study demonstrated that glycemic failure rates in the three treatments combined-metformin plus rosiglitazone, metformin alone, and metformin plus lifestyle-were higher in non-Hispanic blacks (NHB; 52.8%) versus non-Hispanic whites (NHW; 36.6%) and Hispanics (H; 45.0%). Moreover, metformin alone was less effective in NHB versus NHW versus H youth. This study describes treatment-associated changes in adiponectin, insulin sensitivity, and β-cell function over time among the three racial/ethnic groups to understand potential mechanism(s) responsible for this racial/ethnic disparity.Research Design and Methods: TODAY participants underwent periodic oral glucose tolerance tests to determine insulin sensitivity, C-peptide index, and oral disposition index (oDI), with measurements of total and high-molecular-weight adiponectin (HMWA).Results: At baseline NHB had significantly lower HMWA than NHW and H and exhibited a significantly smaller increase (17.3% vs. 33.7% vs. 29.9%, respectively) during the first 6 months overall. Increases in HMWA were associated with reductions in glycemic failure in the three racial/ethnic groups combined (hazard ratio 0.61, P < 0.0001) and in each race/ethnicity separately. Over time, HMWA was significantly lower in those who failed versus did not fail treatment, irrespective of race/ethnicity. There were no differences in treatment-associated temporal changes in insulin sensitivity, C-peptide index, and oDI among the three racial/ethnic groups.Conclusions: HMWA is a reliable biomarker of treatment response in youth with type 2 diabetes. The diminutive treatment-associated increase in HMWA in NHB (∼50% lower) compared with NHW and H may explain the observed racial/ethnic disparity with higher therapeutic failure rates in NHB in TODAY. [ABSTRACT FROM AUTHOR]
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