Determining Predictors of Early Response to Exenatide in Patients with Type 2 Diabetes Mellitus
Determining Predictors of Early Response to Exenatide in Patients with Type 2 Diabetes Mellitus
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DOI：
10.1155/2015/162718
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发表时间：
2015-01-01
影响因子：
4.3
通讯作者：
Joseph, Franklin
中科院分区：
文献类型：
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作者：
Khan, Muhammad;Ouyang, Jing;Joseph, Franklin
埃克塞那肽是一种GLP-1类似物，用于治疗T2 DM，但有一部分患者因不良反应或未能达到最终目标而失败。这项回顾性观察研究的目的是确定我们是否可以预测2型糖尿病患者对艾塞那肽的反应。112名服用艾塞那肽的患者包括患者的年龄、性别、2型糖尿病病程、同时服用艾塞那肽的药物和体重、体重指数、基线时的体重指数和糖化血红蛋白，并记录使用艾塞那肽的3个月和6个月。6个月后，63例患者的HbA1c水平较治疗前降低了11 mm o l/m ol，49例患者对埃塞那肽无效。仅在基线、3个月和6个月时，HbA1c在队列之间存在显著差异(P<；0.05)。回归分析发现较高的基线糖化血红蛋白与6个月后糖化血红蛋白下降幅度较大呈线性负相关(P<；0.0001)。HbA1c是艾塞那肽有效的唯一预测因子，基线HbA1c升高使有效率增加5%(P=0.004)。HbA1c下降15-20%的患者在3个月后更有可能在6个月后有反应(P=0.033)。我们的研究发现，基线HbA1c是艾塞那肽疗效的唯一预测因子，服用艾塞那肽3个月后即可确定疗效。
Exenatide is a GLP-1 analogue used in the management of T2DM yet within a subset of patients fails due to adverse side effects or from failure to attain the end goal. This retrospective observational study aimed to determine whether we could predict response to exenatide in patients with T2DM. 112 patients on exenatide were included with patient age, gender, duration of T2DM, medications alongside exenatide and weight, BMI, and HbA1c at baseline and 3 and 6 months of exenatide use being recorded. 63 responded with 11 mmol/mol reduction from baseline HbA1c after six months and 49 did not respond to exenatide. HbA1c solely differed significantly between cohorts at baseline, 3 months, and 6 months (P < 0.05). Regression analyses identified a negative linear relationship with higher baseline HbA1c correlating to greater reductions in HbA1c by 6 months (P < 0.0001). HbA1c was the sole predictor of exenatide response with higher baseline HbA1c increasing the odds of response by 5% (P = 0.004). Patients with HbA1c reductions >= 15-20% by 3 months were more likely to be responders by 6 months (P = 0.033). Our study identified that baseline HbA1c acted as the sole predictor of exenatide response and that response may be determined after 3 months of exenatide administration.