中国2型糖尿病患者接受双时相门冬胰岛素30治疗后血糖控制达标的预测因素分析:A1chieve研究亚组数据

Predictors of good glycaemic control in Chinese T2DM patients treated with biphasic insulin aspart 30:Data from the A1chieve study

目的预测T2DM患者由预混人胰岛素(BHI30)转为双时相门冬胰岛素30(BIAsp30)后治疗达标的基线特征。方法纳入A1chieve研究中BHI30血糖控制效果不佳而转用BIAsp30治疗的中国患者,以治疗24周后HbA_1c是否达标(<7.0%)为因变量,患者基线特征为自变量,行单因素及多因素回归分析。结果基线HbA_1c、FPG及体重是患者接受BIAsp30治疗后HbA_1c达标的预测因素。基线HbA_1c水平每增加1%,治疗后HbA_1c达标的可能性降低25%;基线FPG水平每增加1mmol/L,治疗后HbA_1c达标的可能性降低7%;基线体重每增加1kg,治疗后HbA_1c达标的可能降低2%。结论本研究提示,由BHI30转为BIAsp30治疗,患者基线HbA_1c、FPG及体重越低,血糖控制的达标率越高。

Objective To investigate the baseline characteristics which could predict the achievement of HbA1 c target（〈7.0%）by biphasic insulin aspart 30（BIAsp 30）in Chinese T2DM patients inadequately controlled on biphasic human insulin 30（BHI 30）. Methods This was a sub-analysis of A1 chieve study including Chinese T2DM patients switching from BHI 30 to BIAsp 30.Univariate logistic regression analyses were performed using HbA1 c reaching target or not after 24 weeks of treatment as dependent variable,and baseline demographics and clinical characteristics as independent variables,respectively.Significant factors were carried forward to multivariate logistic regression analyses. Results Multivariate analyses revealed that,baseline HbA1c[OR（95%CI）：0.745（0.6770.819）,P〈0.0001],FPG [OR（95%CI）：0.926（0.8620.995）,P=0.0368]and body weight[OR（95%CI）：0.981（0.9650.998）,P=0.0245]were significant predictors of the achievement of HbA1c〈7.0% after 24 weeks of BIAsp 30 treatment.Each increase of 1%in baseline HbA1c provides a decrease of 25%in the possibility of reaching HbA1c〈7%;each increase of baseline FPG of 1 mmol/L provides a decrease of 7% in the possibility of reaching HbA1c〈7.0%;each increase of 1kg in baseline body weight provides a decrease of2 %in the possibility of reaching HbA1c〈7%. Conclusion This study indicates that patients with lower HbA1 c,FPG and body weight levels at baseline are more likely to reach HbA1 c target of〈7% after switching from BHI 30 to BIAsp 30.