Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui, Japan.
J Diabetes Investig. 2012 Mar 28;3(2):170-4. doi: 10.1111/j.2040-1124.2011.00156.x.
Aims/Introduction: The aim of the present study was to assess the independent predictors of the HbA1c-lowering effect of sitagliptin in Japanese type 2 diabetic patients.
Data were retrieved from the medical records of 151 type 2 diabetic patients who had been taking sitagliptin 25 or 50 mg once daily for inadequate glycemic control for at least 12 weeks, with or without other oral hypoglycemic agents. Spearman's rank correlation coefficients were calculated to investigate correlations between two independent continuous variables. Multiple stepwise regression analysis was used to identify independent predictors of reductions in HbA1c levels after 12 weeks of sitagliptin treatment (ΔHbA1c).
In all patients combined, Spearman's rank correlation coefficients showed that ΔHbA1c was significantly correlated with baseline HbA1c alone (r = 0.371, P < 0.0001). However, multiple linear regression analysis among all patients using baseline variables revealed that the independent factors contributing to ΔHbA1c, in order of importance, were method of prescribing (P < 0.0001), baseline HbA1c (P < 0.0001), body mass index (BMI; P = 0.004), and duration of diabetes (P = 0.024).
Our analysis may provide novel evidence that increased BMI contributes, in part, to attenuation of the HbA1c-lowering effect of sitagliptin in Japanese type 2 diabetic patients. Analysis of a larger population over a longer period of time is warranted to confirm these findings. (J Diabetes Invest, doi: 10.1111/j.2040-1124.2011.00156.x, 2011).
目的/引言:本研究旨在评估西他列汀降低日本 2 型糖尿病患者糖化血红蛋白(HbA1c)水平的独立预测因子。
从 151 例因血糖控制不佳而服用西他列汀 25 或 50mg 每日一次,联合或不联合其他口服降糖药至少 12 周的 2 型糖尿病患者的病历中提取数据。采用斯皮尔曼等级相关系数分析两个独立连续变量之间的相关性。采用多元逐步回归分析确定西他列汀治疗 12 周后 HbA1c 水平降低的独立预测因子(ΔHbA1c)。
在所有患者中,斯皮尔曼等级相关系数显示,ΔHbA1c 与基线 HbA1c 显著相关(r=0.371,P<0.0001)。然而,在所有患者中使用基线变量进行多元线性回归分析显示,对ΔHbA1c 有重要影响的独立因素依次为:用药方式(P<0.0001)、基线 HbA1c(P<0.0001)、体重指数(BMI;P=0.004)和糖尿病病程(P=0.024)。
我们的分析可能为新证据提供支持,即增加 BMI 部分导致西他列汀降低日本 2 型糖尿病患者 HbA1c 水平的作用减弱。需要更大的人群和更长的时间进行分析,以确认这些发现。