Central Obesity but Not BMI Related to Hypoglycemic Efficacy of Metformin—Subanalysis of MARCH Study

Abstract

Objective: MARCH study(Metformin and AcaRbose in Chinese as the initial Hypoglycaemic treatment) was a nationwide, multicenter, randomized controlled trial in China (Chinese Clinical Trial Registry, number ChiCTR-TRC-08000231), and confirmed that Acarbose was non-inferior to Metformin in terms of hypoglycemic effectiveness among Chinese patients with newly-diagnosed type 2 diabetes. The purpose of this paper was to understand the association between the efficacy of Acarbose and Metformin and the parameters reflected body weight. Method: A total of 788 participants from MARCH database were included in this analysis. The participants were divided into four BMI groups(BMI 19-23.9, 24-25.9, 26-27.9, and 28-30kg/m2) and four weight loss groups according to quartile of weight change from the baseline, and two central obesity groups according to IDF criteria(i.e., waist circumference >=90cm in male, >=80cm in female), respectively. ANCOVA was used to assess the association of the above obesity categories with the changes of HbA1c from baseline in Acarbose group and Metformin group respectively, with treatment and center as factors, and baseline HbA1c as a covariate. Result: There was no significant difference in change from baseline HbA1c within the acarbose group (0.98%,0.95%,1.20%,1.14%,p=0.1476) as well as the metformin group (1.08%,1.12%,1.20%,1.32%,p=0.2918) when patients were stratified by BMI quartile. The reduction in HbA1c was greater in patients with central obesity than those without in Metformin treatment group[1.26%(95% CI:1.15%-1.37%) vs.0.98%(95% CI:0.81%-1.15%),p=0.0059], but there was no significant difference among patients with and without central obesity for HbA1c reduction in acarbose treatment group[1.10%(95% CI:0.98%-1.21%) vs. 0.97%(95% CI:0.81%-1.13%),p=0.2037]. Conclusion: The hypoglycemic efficacy of acarbose is not associated with the obesity status. In contrast, Metformin was more effective in patients with central obesity. Disclosure Z. Yang: None. X. Wang: None. N. Wang: None. X. Jin: None. J. Zhang: None. X. Zhang: None. W. Yang: None.