Treatment effects on measures of body composition in the TODAY clinical trial.

Authors

Kenneth C. Copeland, University of OklahomaFollow
Janine A. Higgins, University of Colorado at Denver and Health Sciences Center
Laure El Ghormli, George Washington University
Linda M. Delahanty, Massachusetts General Hospital
Margaret Grey, Yale University
Andrea M. Kriska, Children's Hospital of Pittsburgh
Terri H. Lipman, Children's Hospital of Philadelphia
Laura Pyle, George Washington University
John A. Shepherd, University of California - San Francisco
Kathryn Hirst, George Washington University

Document Type

Journal Article

Publication Date

6-2013

Journal

Diabetes Care

Volume

Volume 36, Issue 6

Inclusive Pages

1742-1748

Keywords

Body Composition--physiology; Diabetes Mellitus, Type 2--drug therapy; Metformin--therapeutic use; Thiazoles--therapeutic use

Abstract

OBJECTIVE The Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) trial showed superiority of metformin plus rosiglitazone (M+R) over metformin alone (M), with metformin plus lifestyle (M+L) intermediate in maintaining glycemic control. We report here treatment effects on measures of body composition and their relationships to demographic and metabolic variables including glycemia.

RESEARCH DESIGN AND METHODS Measures of adiposity (BMI, waist circumference, abdominal height, percent and absolute fat, and bone mineral content [BMC] and density [BMD]) were analyzed as change from baseline at 6 and 24 months.

RESULTS Measures of fat accumulation were greatest in subjects treated with M+R and least in M+L. Although fat measures in M+L were less than those of M+R and M at 6 months, differences from M were no longer apparent at 24 months, whereas differences from M+R persisted at 24 months. The only body composition measure differing by race and/or ethnicity was waist circumference, greater in M+R than either M or M+L at both 6 and 24 months in whites. BMD and BMC increased in all groups, but increased less in M+R compared with the other two groups by 24 months. Measures of adiposity (increases in BMI, waist circumference, abdominal height, and fat) were associated with reduced insulin sensitivity and increased hemoglobin A_1c (HbA_1c), although effects of adiposity on HbA_1c were less evident in those treated with M+R.

CONCLUSIONS Despite differential effects on measures of adiposity (with M+R resulting in the most and M+L in the least fat accumulation), group differences generally were small and unrelated to treatment effects in sustaining glycemic control.

Comments

Reproduced with permission of the American Diabetes Association. Diabetes Care.

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

APA Citation

Copeland, K. C., Higgins, J., El Ghormli, L., Delahanty, L., Grey, M., Kriska, A. M., . . . Hirst, K. (2013). Treatment effects on measures of body composition in the TODAY clinical trial. Diabetes Care, 36(6), 1742-1748.

Peer Reviewed

1

Open Access

1