维拉帕米尔对新诊断的儿童1型糖尿病的胰腺β细胞功能的影响:随机临床试验
Gregory P Forlenza1, Jennifer McVean2,3, Roy W Beck4
1Barbara Davis Center, Anschutz Medical Campus, University of Colorado, Aurora.
JAMA
|February 24, 2023
概括
与安慰剂相比,维拉帕米尔治疗新诊断的1型糖尿病儿童和青少年的胰腺β细胞功能部分保持,C水平在52周后增加了30%.
科学领域:
- 内分泌学
- 免疫学
- 临床药理学
背景情况:
- 在胰腺β细胞中过度表达硫素相互作用蛋白 (TXNIP) 会导致细胞亡,并与葡萄糖毒性有关.
- 通道阻断剂 (CCB) 显示出缓解这些影响的潜力,这表明它们在1型糖尿病中对β细胞的保护起作用.
研究的目的:
- 评估维拉帕米尔 (CCB) 在刚被诊断为1型糖尿病的儿童和青少年的胰腺β细胞功能的有效性.
主要方法:
- 这是一项双盲随机临床试验,涉及88名新诊断为1型糖尿病的参与者 (年龄为7-17岁).
- 参与者每天服用维拉帕米尔或安慰剂,持续52周.
- 主要测量结果是C水平的变化 (β细胞功能的标志物) 通过混合食耐受性测试.
主要成果:
- 与安慰剂相比,在52周内,维拉帕米尔治疗导致C刺激水平提高了30% (0. 65对0. 44 pmol/ ml).
- 与安慰剂组 (71%) 相比,维拉帕米尔 (95%) 的参与者保持C水平≥0. 2 pmol/ ml.
- 血红蛋白A1c水平在不同组之间是可比的,并且不良事件是相似的.
结论:
- 在患有1型糖尿病的儿童和青少年中,维拉帕米尔在52周内部分保留了刺激的C分泌.
- 需要进一步的研究来评估这些效应的长期持续性,并确定最佳的治疗持续时间.
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