Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
J Korean Med Sci. 2013 Jun;28(6):881-7. doi: 10.3346/jkms.2013.28.6.881. Epub 2013 Jun 3.
We investigated characteristics associated with the efficacy of dipeptidyl peptidase-4 inhibitors (DPP4i) in Korean patients with type 2 diabetes. We reviewed medical records of 477 patients who had taken sitagliptin or vildagliptin longer than 40 weeks. Response to DPP4i was evaluated with HbA1c change after therapy (ΔHbA1c). The Student's t-test between good responders (GR: ΔHbA1c > 1.0%) and poor responders (PR: ΔHbA1c < 0.5%), a correlation analysis among clinical parameters, and a linear multivariate regression analysis were performed. The mean age was 60 yr, duration of diabetes 11 yr and HbA1c was 8.1%. Baseline fasting plasma glucose (FPG), HbA1c, C-peptide, and creatinine were significantly higher in the GR compared to the PR. Duration of diabetes, FPG, HbA1c, C-peptide and creatinine were significantly correlated with ΔHbA1c. In the multivariate analysis, age (r(2) = 0.006), duration of diabetes (r(2) = 0.019), HbA1c (r(2) = 0.296), and creatinine levels (r(2) = 0.024) were independent predictors for the response to DPP4i. Body mass index and insulin resistance were not associated with the response to DPP4i. In conclusion, better response to DPP4i would be expected in Korean patients with type 2 diabetes who have higher baseline HbA1c and creatinine levels with shorter duration of diabetes.
我们研究了与二肽基肽酶-4 抑制剂（DPP4i）在韩国 2 型糖尿病患者中的疗效相关的特征。我们回顾了 477 例服用西格列汀或维格列汀超过 40 周的患者的病历。通过治疗后 HbA1c 的变化（ΔHbA1c）评估 DPP4i 的反应。用学生 t 检验比较良好反应者（GR：ΔHbA1c＞1.0%）和不良反应者（PR：ΔHbA1c＜0.5%），对临床参数进行相关分析，并进行线性多元回归分析。平均年龄为 60 岁，糖尿病病程为 11 年，HbA1c 为 8.1%。GR 的基线空腹血糖（FPG）、HbA1c、C 肽和肌酐明显高于 PR。糖尿病病程、FPG、HbA1c、C 肽和肌酐与ΔHbA1c 显著相关。在多元分析中，年龄（r²=0.006）、糖尿病病程（r²=0.019）、HbA1c（r²=0.296）和肌酐水平（r²=0.024）是 DPP4i 反应的独立预测因素。体重指数和胰岛素抵抗与 DPP4i 的反应无关。总之，基线 HbA1c 和肌酐水平较高、糖尿病病程较短的韩国 2 型糖尿病患者对 DPP4i 的反应更好。
