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基线体重指数状态对2型糖尿病患者使用西他列汀治疗期间血糖降低及体重变化的影响。

Impact of baseline body mass index status on glucose lowering and weight change during sitagliptin treatment for type 2 diabetics.

作者信息

Chen Jung-Fu, Chang Chih-Min, Kuo Ming-Chun, Tung Shih-Chen, Tsao Cheng-Feng, Tsai Chia-Jen

机构信息

Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 123, Ta-Pei Road, Niao-Sung District, Kaohsiung City, Taiwan, ROC.

Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 123, Ta-Pei Road, Niao-Sung District, Kaohsiung City, Taiwan, ROC.

出版信息

Diabetes Res Clin Pract. 2016 Oct;120:8-14. doi: 10.1016/j.diabres.2016.07.009. Epub 2016 Jul 28.

Abstract

AIMS

This study was designed to evaluate the efficacy of sitagliptin in Taiwanese diabetic subjects with different baseline BMI status.

METHODS

This was a single-center, hospital-based, retrospective chart review in subjects (n=1874) with type 2 diabetes who received sitagliptin. Subjects were classified into subgroups depending upon their baseline BMI by Taiwan national weight classification: normal (BMI<24kg/m(2)) (n=504), overweight (BMI: 24-27kg/m(2)) (n=615), and obese (BMI⩾27kg/m(2)) (n=755). Changes in HbA1c and weight were evaluated over a 12month treatment period.

RESULTS

For all three groups, the HbA1c levels declined over the first three months by about 8%, and subsequently plateaued for the next nine months. Obese subjects were slower in reducing HbA1c compared with normal and overweight subjects (P<0.05), but at nine months the reduction was similar across groups. Mean body weight increased over the first nine months of sitagliptin therapy in subjects with normal BMI (57.12-58.30kg), but there was no change in mean body weight in the overweight group. After three months the obese groups had significantly greater loss in body weight compared with the normal group.

CONCLUSIONS

Baseline BMI status may influence the reduction of HbA1c levels within the first six months of sitagliptin therapy and affect weight change after three months. Being obese was associated with an initial lag in HbA1c reduction and greater weight loss compared with normal and overweight subjects.

摘要

目的

本研究旨在评估西格列汀对不同基线体重指数(BMI)状态的台湾糖尿病患者的疗效。

方法

这是一项基于医院的单中心回顾性病历审查,研究对象为1874例接受西格列汀治疗的2型糖尿病患者。根据台湾国民体重分类标准,将患者按基线BMI分为亚组:正常(BMI<24kg/m²)(n=504)、超重(BMI:24-27kg/m²)(n=615)和肥胖(BMI⩾27kg/m²)(n=755)。在12个月的治疗期内评估糖化血红蛋白(HbA1c)和体重的变化。

结果

在所有三组中,HbA1c水平在最初三个月下降了约8%,随后在接下来的九个月趋于平稳。与正常和超重患者相比,肥胖患者降低HbA1c的速度较慢(P<0.05),但在九个月时各组的降低幅度相似。在接受西格列汀治疗的前九个月,正常BMI患者(57.12-58.30kg)的平均体重增加,但超重组的平均体重没有变化。三个月后,肥胖组的体重减轻明显大于正常组。

结论

基线BMI状态可能会影响西格列汀治疗前六个月内HbA1c水平的降低,并在三个月后影响体重变化。与正常和超重患者相比,肥胖与HbA1c降低的初始滞后和更大的体重减轻有关。

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