Evidence map›Paper›PMID 39400888›Full record

Trial reportJournal of endocrinological investigation2025

Effects of acarbose and metformin on thyroid function and thyroid hormone sensitivity in type 2 diabetes patients: a post-hoc analysis of the MARCH study.

Chenyu Zhang, Aihua Liu, Weiping Teng, Wenying Yang, Jing Li, Zhongyan Shan

Abstract readClinical Trial, Phase IVEquivalence TrialMulticenter Study
PubMed Publisher
In one paragraph

Trial report in Journal of endocrinological investigation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Chenyu Zhang *Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, No. 155 Nanjing Bei Street, Shenyang, Liaoning, 110001, P. R. China.
Aihua Liu *Department of Endocrinology, Peking University Third Hospital, Beijing, 100191, China.
Weiping TengDepartment of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, No. 155 Nanjing Bei Street, Shenyang, Liaoning, 110001, P. R. China.
Wenying YangDepartment of Endocrinology, China-Japan Friendship Hospital, Beijing, 100029, P. R. China.
Jing LiDepartment of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, No. 155 Nanjing Bei Street, Shenyang, Liaoning, 110001, P. R. China. lijingendocrine@126.com.
Zhongyan ShanDepartment of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, No. 155 Nanjing Bei Street, Shenyang, Liaoning, 110001, P. R. China. cmushanzhongyan@163.com.ORCID http://orcid.org/0000-0002-2849-2380

Funding

Chinese National Natural Science Foundation 81700697Chinese National Natural Science Foundation 81970682National Natural Science Foundation of China 72374007
6 · The paper itself

Abstract

purposeWhile metformin is known to regulate thyroid stimulating hormone (TSH) levels, the effects of acarbose on thyroid function remain unreported. Our study was designed to evaluate the impact of acarbose and metformin on thyroid function and thyroid hormone sensitivity in type 2 diabetic patients.

methodsIn the MARCH study, 788 patients with type 2 diabetes were randomly assigned to treat with acarbose (300 mg) or metformin (1,500 mg) for 48 weeks. Thyroid function was assessed at baseline, 24 weeks, and 48 weeks, and the thyroid feedback quantile index (TFQI) and parameterized thyroid feedback quantile index (PTFQI) were calculated. Generalized estimating equations adjusted for confounders were used to analyze changes over time.

resultsEighty-four patients with subclinical hypothyroidism (SCH) exhibited a decrease in TSH levels (p = 0.001) with no significant differences between the two treatment groups (p = 0.460). Both TFQI (p = 0.029) and PTFQI (p < 0.001) also decreased over time. Mediation analysis revealed that these change over time were not mediated by BMI (all p < 0.05). Among the 489 euthyroid subjects, no significant changes in TSH levels were observed (p > 0.05). Stratification by baseline TSH levels revealed significant increases in TSH, TFQI, and PTFQI (all p < 0.05) in the normal-low TSH group and significant decreases in PTFQI (all p < 0.05) in the normal-high TSH group after treatment with acarbose and metformin.

conclusionsAcarbose and metformin have similar buffering effects on TSH levels, the TFQI and the PTFQI. In patients with lower TSH levels, acarbose and metformin do not further decrease TSH levels. CLINICAL TRIAL REGISTRY NUMBER: ChiCTR-TRC-08000231.

Indexed as

AcarboseDiabetes Mellitus, Type 2Hypoglycemic AgentsHypothyroidismMetforminThyroid GlandThyroid HormonesAgedFemaleFollow-Up StudiesHumansMaleMiddle AgedThyroid Function TestsThyrotropinAcarboseHypoglycemic AgentsMetforminThyroid HormonesThyrotropinAcarboseMetforminThyroid dysfunctionTSHType 2 diabetes

Identifiers

PMID39400888

What Socratic holds

Texttitle and abstract
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.