CAJ | 학술논문

目的探索二甲双胍单药治疗中国新诊断2型糖尿病（T2DM）患者临床疗效的预测因素。方法选取2008年11月至2011年6月参加“阿卡波糖对中国新诊断T2DM患者的作用机制研究”（MARCH研究）的二甲双胍单药治疗48周的患者为研究对象，以糖化血红蛋白降低值（ΔHbA1c）为因变量，以基线各参数为自变量进行多元线性回归分析。结果（1）本研究共纳入354例新诊断T2DM患者，男性208例，女性146例，平均年龄（50±9）岁，平均病程（3.3±5.0）个月；（2）多元线性回归结果显示，12周时对ΔHbA1c的独立影响因素：HbA1c、空腹血糖（FPG）（β=-0.924、0.216，t=-27.71、6.24，均P<0.01）、舒张压（DBP）、稳态模型胰岛素抵抗指数（HOMA-IR）、胰高血糖素曲线下面积（AUCglucagon）、胰高血糖素样肽1（GLP-1）曲线下面积（AUCGLP-1）（β=-0.075~0.076，t=-2.33~2.49，均P<0.05）；（3）48周ΔHbA1c的独立影响因素：HbA1c（β=-0.860，t=-23.40，P<0.01）及FPG（β=0.106，t=2.89， P=0.004）。结论二甲双胍对具有较高基线HbA1c、HOMA-IR、AUCGLP-1及较低FPG、AUCglucagon的新诊断T2DM患者疗效更好。
목적탐색이갑쌍고단약치료중국신진단2형당뇨병（T2DM）환자림상료효적예측인소。방법선취2008년11월지2011년6월삼가“아잡파당대중국신진단T2DM환자적작용궤제연구”（MARCH연구）적이갑쌍고단약치료48주적환자위연구대상，이당화혈홍단백강저치（ΔHbA1c）위인변량，이기선각삼수위자변량진행다원선성회귀분석。결과（1）본연구공납입354례신진단T2DM환자，남성208례，녀성146례，평균년령（50±9）세，평균병정（3.3±5.0）개월；（2）다원선성회귀결과현시，12주시대ΔHbA1c적독립영향인소：HbA1c、공복혈당（FPG）（β=-0.924、0.216，t=-27.71、6.24，균P<0.01）、서장압（DBP）、은태모형이도소저항지수（HOMA-IR）、이고혈당소곡선하면적（AUCglucagon）、이고혈당소양태1（GLP-1）곡선하면적（AUCGLP-1）（β=-0.075~0.076，t=-2.33~2.49，균P<0.05）；（3）48주ΔHbA1c적독립영향인소：HbA1c（β=-0.860，t=-23.40，P<0.01）급FPG（β=0.106，t=2.89， P=0.004）。결론이갑쌍고대구유교고기선HbA1c、HOMA-IR、AUCGLP-1급교저FPG、AUCglucagon적신진단T2DM환자료효경호。
Objective To analyze the predictive parameters for therapeutic efficacy of metformin monotherapy in Chinese newly diagnosed patients with type 2 diabetes. Methods Subjects who were treated with metformin monotherapy for 48 weeks from“Study on the Mechanism of acarbose in Chinese Newly diagnosed Type 2 Diabetic Patient”(MARCH study) from November 2008 to June 2011 were enrolled. To assess the predictive parameters for therapeutic efficacy, a multiple linear regression analysis was performed, taking glycosylated hemoglobin (HbA1c) reduction as a dependent variable, and baseline parameters as independent variables. Results (1) A total of 354 patients (208 men and 146 women) with type 2 diabetes were enrolled. The mean age was(50±9)yrs, and the mean duration of diabetes was (3.3±5.0) months. (2) Multiple linear regression analysis indicated that baseline HbA1c, fasting plasma glucose (FPG) (β=-0.924, 0.216, t=-27.71, 6.24, all P<0.01), diastolic blood pressure (DBP), homeostasis model assessment of insulin resistance (HOMA-IR), area under the curve of glucagon (AUCglucagon) and area under the curve of plasma glucagon-like peptide-1 (AUCGLP-1) (β=-0.075-0.076, t=-2.33-2.49, all P<0.05) were independent influencing factors forΔHbA1c at week 12;(3) HbA1c (β=-0.860, t=-23.40, P<0.01) and FPG (β=0.106, t=2.89, P=0.004)were independent influencing factors for ΔHbA1c at week 48. Conclusion Metformin may be more effective in patients with newly diagnosed type 2 diabetes with higher baseline HbA1c, HOMA-IR, AUCGLP-1 and lower FPG and AUCglucagon.