Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Republic of Korea.
PLoS One. 2019 Aug 1;14(8):e0220667. doi: 10.1371/journal.pone.0220667. eCollection 2019.
We aimed to investigate the clinical factors affecting the therapeutic effectiveness of the sodium-glucose cotransporter-2 inhibitor empagliflozin in patients with type 2 diabetes mellitus (T2DM). We reviewed the medical records of 374 T2DM patients aged between 20 and 75 years who were prescribed empagliflozin 10 mg or 25 mg as add-on therapy for more than 90 consecutive days. Changes in hemoglobin A1c (HbA1c) from baseline levels and the reduction in body weights of the study participants were assessed. We found that younger patients (≤ 50 years), patients with the highest levels of HbA1c (>9%) at baseline, patients with an estimated glomerular filtration rate (eGFR) of >90 mL/min/1.73 m2, and patients with a shorter duration of T2DM (< 10 years) were more likely to exhibit a better glycemic response. Multivariate linear regression analysis revealed that a shorter duration of T2DM, higher baseline levels of HbA1c, and higher eGFR were positively associated with HbA1c reduction. Higher BMI and lower HbA1c levels were predictors of a more significant reduction in body weight among patients taking empagliflozin. The glucose-lowering effect of empagliflozin was more evident in T2DM patients with higher baseline HbA1c levels, better renal function, and shorter duration of T2DM.
我们旨在探讨影响钠-葡萄糖共转运蛋白-2 抑制剂恩格列净治疗 2 型糖尿病（T2DM）患者疗效的临床因素。我们回顾了 374 例年龄在 20 至 75 岁之间的 T2DM 患者的病历，这些患者在 90 天以上的时间内接受了恩格列净 10mg 或 25mg 的附加治疗。评估了研究参与者的血红蛋白 A1c（HbA1c）从基线水平的变化和体重减轻情况。我们发现，年龄较小（≤50 岁）、基线 HbA1c 水平最高（>9%）、估算肾小球滤过率（eGFR）>90mL/min/1.73m2 的患者以及 T2DM 病程较短（<10 年）的患者，血糖反应更好。多变量线性回归分析显示，T2DM 病程较短、基线 HbA1c 水平较高以及 eGFR 较高与 HbA1c 降低呈正相关。较高的 BMI 和较低的 HbA1c 水平是恩格列净治疗患者体重减轻更显著的预测因素。恩格列净的降糖作用在基线 HbA1c 水平较高、肾功能较好以及 T2DM 病程较短的 T2DM 患者中更为明显。
