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新发 2 型糖尿病患者的体重变化及其与缓解的关系:综合真实世界数据。

Weight change in patients with new-onset type 2 diabetes mellitus and its association with remission: Comprehensive real-world data.

机构信息

Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.

出版信息

Diabetes Obes Metab. 2024 Feb;26(2):567-575. doi: 10.1111/dom.15345. Epub 2023 Nov 8.

Abstract

AIMS

We aimed to investigate weight change in patients with new-onset type 2 diabetes mellitus and the association of weight loss on diabetes remission in Korean adults.

MATERIALS AND METHODS

We used the health examination database of the Korean National Health Insurance Service. Patients diagnosed with type 2 diabetes mellitus from 2009 to 2012 were enrolled and followed to 2017. The baseline body weight was measured at the health examination closest to the time the patient was enrolled, and the change was calculated by examining the weight measured at the subsequent examination within 2 years. Remission was defined as fasting blood glucose less than 126 mg/dl at two or more consecutive health examinations after stopping medication.

RESULTS

In total, 114, 874 patients with new-onset type 2 diabetes mellitus were analysed. Of these, 23 156 (20.2%) lost more than 5% of their body weight, and 2429 (2.1%) achieved remission. The adjusted odds ratio for remission in the weight loss group was 2.56 (95% confidence interval 2.35-2.79) compared with the group with stable body weight. Sensitivity analysis according to the degree of weight change showed that the greater weight loss, the higher the likelihood of remission. In the subgroup analysis, the effects of weight loss on remission were significantly greater in subgroups of age <65 years, male sex and body mass index >25.

CONCLUSION

Weight loss within the first 2 years of treating type 2 diabetes mellitus was associated with diabetes remission. Physicians should pay more attention to weight management in new-onset type 2 diabetes mellitus, particularly for young and obese individuals.

摘要

目的

本研究旨在探讨新发 2 型糖尿病患者的体重变化,并分析体重减轻与韩国成年人糖尿病缓解的相关性。

材料与方法

我们使用了韩国国家健康保险服务的健康检查数据库。纳入了 2009 年至 2012 年期间被诊断为 2 型糖尿病的患者,并随访至 2017 年。基线体质量在患者入组前最近一次健康检查时测量,随后通过在 2 年内检查后续检查时的体重计算体重变化。停药后连续两次或两次以上健康检查时空腹血糖<126mg/dl 定义为缓解。

结果

共分析了 114874 例新发 2 型糖尿病患者。其中,23156 例(20.2%)体重减轻超过 5%,2429 例(2.1%)达到缓解。与体重稳定组相比,体重减轻组缓解的调整优势比为 2.56(95%置信区间 2.35-2.79)。根据体重变化程度的敏感性分析显示,体重减轻程度越大,缓解的可能性越高。亚组分析显示,体重减轻对缓解的影响在年龄<65 岁、男性和体质指数>25 的亚组中更为显著。

结论

在治疗 2 型糖尿病的前 2 年内体重减轻与糖尿病缓解相关。医生应更加关注新发 2 型糖尿病患者的体重管理,尤其是对于年轻和肥胖患者。

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