Gender difference in response predictors after 1-year exenatide therapy twice daily in type 2 diabetic patients: a real world experience.
Gender difference in response predictors after 1-year exenatide therapy twice daily in type 2 diabetic patients: a real world experience.
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DOI：
10.2147/dmso.s42729
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发表时间：
2013
期刊：
影响因子：
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通讯作者：
Baccetti F
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文献类型：
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作者：
Anichini R;Cosimi S;Di Carlo A;Orsini P;De Bellis A;Seghieri G;Franconi F;Baccetti F
通过使用托斯卡纳（意大利）5家门诊监测的患者数据库，研究性别是否影响2型糖尿病患者每日两次（BID）艾塞那肽的治疗反应。我们考虑了315例（154例男性/161例女性）口服治疗（二甲双胍或二甲双胍+磺脲类联合治疗）失败的患者，这些患者接受艾塞那肽（10 μg/BID）治疗，并完全完成了4个月、8个月和12个月的随访。在按性别分层且年龄、体重指数和血红蛋白A1 c（HbA 1c）匹配良好的患者中，发现女性的病程长于男性（12 ± 8年vs 10 ± 7年; P = 0.037），男性中接受二甲双胍治疗的患者与接受联合治疗的患者的比例较高（P = 0.018）。男性达到目标血糖缓解（1年HbA 1c ≤ 7%）的比例显著高于女性（38% vs 27%; χ2 = 4.66; P = 0.03）。在8个月和12个月时，女性的目标体重减轻（表示为1年体重相对于基线下降的百分比≥第75百分位数（8.5%））显著更高（P < 0.05;两者均如此）。在男性中，1年血糖目标应答与基线HbA 1c水平和糖尿病病程呈负相关，而二甲双胍治疗（与口服联合治疗相比）是女性中更好血糖目标的重要预测因素。在117例患者中测量的稳态模型评估-B仅预测女性的低血糖反应（P = 0.009）。男性糖尿病病程较长和女性基线HbA 1c较低可预测目标1年体重减轻。最后，在exenglutamine治疗后的胃肠道副作用方面，性别之间没有显著差异。根据这一“真实的世界”经验，在2型糖尿病患者中，艾塞那肽BID治疗12个月后血糖控制和体重减轻的预测因素在性别之间是不同的。
To investigate whether gender affects therapeutic response by exenatide twice a day (BID) in type 2 diabetes by using a database concerning patients monitored by five outpatient clinics in Tuscany, Italy. We considered a cohort of 315 (154 male/161 female) patients experiencing therapeutic failure while on oral therapy (metformin, or combination therapy metformin + sulphonylureas), who were given exenatide (10 μg/BID) and who fully completed 4 months, 8 months, and 12 months of follow-ups. Among patients stratified by gender and well matched for age, body mass index, and hemoglobin A1c (HbA1c), it was found that the length of disease was longer in females than in males (12 ± 8 years versus 10 ± 7 years; P = 0.037), and the ratio of patients on metformin to those on combination therapy was higher in men (P = 0.018). Target glycemic response (1-year HbA1c ≤ 7%) was achieved in a significantly higher proportion of males than females (38% versus 27%; χ2 = 4.66; P = 0.03). Target weight loss expressed as 1-year weight percent fall from baseline ≥ 75th percentile (8.5%) was significantly higher in females at 8 and 12 months (P < 0.05; for both). One-year glycemic target response was inversely related to baseline HbA1c levels and diabetes duration among males, while metformin therapy (compared to oral combination therapy) was a significant predictor of better glycemic targets among females. Homeostasis model assessment-B, measured in 117 patients, predicted hypoglycemic response only in women (P = 0.009). Target 1-year weight loss was predicted by longer diabetes duration among males and by lower baseline HbA1c among females. Finally, no significant difference between genders was noted as to gastrointestinal side effects after exenatide therapy. According to this “real world” experience, predictors of glycemic control and body weight loss after 12 months of exenatide BID therapy are different between genders in type 2 diabetes.