比较曾接受达帕格列净或其他口服降糖药物二线治疗的 2 型糖尿病患者的基线临床特征:AGORA 研究。

IF 1.9 Q3 PERIPHERAL VASCULAR DISEASE Clinica e Investigacion en Arteriosclerosis Pub Date : 2024-06-22 DOI:10.1016/j.arteri.2024.05.001
Vicente Pallarés-Carratalá, Antonio Ruiz-García, Adalberto Serrano-Cumplido, Antonio Segura Fragoso, Verónica Fernández-Pascual, Beatriz Sánchez-Sánchez, María Inmaculada Cervera-Pérez, Francisco Javier Alonso-Moreno, Ezequiel Arranz-Martínez, Alfonso Barquilla-García, Daniel Rey-Aldana, José Polo García, Sergio Cinza-Sanjurjo
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引用次数: 0

摘要

引言2 型糖尿病(T2D)已成为全球流行病。近年来,新的口服降糖药(OGLD)不断涌现,改善了T2D患者的心血管-肾脏-代谢控制:比较 AGORA 研究人群中接受达帕格列净(DAPA 组)或其他 OGLD(SOC 组)二线降糖治疗的 T2D 患者的基线临床生物学特征:这是一项多中心横断面观察性研究,通过竞争性抽样在西班牙的 46 个初级保健中心招募 T2D 患者参与 AGORA 研究。报告中介绍了纳入和排除参与者的标准,以及样本量的合理性。在核实评估所需数据和知情同意后,317 名受试者被纳入 DAPA 组,288 名受试者被纳入 SOC 组。对分类变量和连续变量进行了分析,并与常规统计方法进行了比较。科恩氏d用于评估平均值的标准化差异:共评估了 65 名 T2D 患者(平均年龄 63.5 [SD±8.1] 岁,61.8% 为男性),其中 17.4% 为吸烟者,47.6% 为肥胖者,74.8% 为高血压患者,87.3% 为血脂异常患者,41.7% 为缺乏运动者。T2D的平均(标清)演变时间为10.1(5.6)年。两组在招募时的大多数基线临床生物特征相似。然而,与 SOC 组相比,DAPA 组更年轻(2.9 岁),收缩压(SBP)更低(2.8mmHg),体重(BW)更高(3.7kg),糖化血红蛋白 A1c(HbA1c)更高(0.3%)。只有 11.5% 的参与者在招募时血糖控制不佳(HbA1c>8%),54.9% 的参与者血糖控制良好(HbA1cConclusions):在二线降糖治疗中添加达帕格列净的T2D患者与添加其他OGLD的患者的大多数心血管-肾脏-代谢特征相似。然而,加用达帕格列净的患者VR较高、SBP较低、体重较高,HbA1c控制稍差。未来的研究有必要解释这些心脏代谢控制差异的原因。
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Comparison of baseline clinical characteristics among people with type 2 diabetes on second-line therapy previously added with dapagliflozin or another oral glucose-lowering drug: AGORA study.

Introduction: Type 2 diabetes mellitus (T2D) has acquired epidemic proportions worldwide. In recent years, new oral glucose-lowering drugs (OGLD) have emerged that improve the cardiovascular-kidney-metabolic control in T2D people.

Objectives: To compare the baseline clinical-biological characteristics among T2D people to whom had added-on dapagliflozin (DAPA group) or another OGLD (SOC group) second-line hypoglycaemic therapies among the AGORA study population.

Methods: This is a multicentre cross-sectional observational study of the baseline characteristics of T2D people recruited through competitive sampling among 46 primary care health centres in Spain for the AGORA study. The inclusion and exclusion criteria of participants, and justification of the sample size are reported. After verifying the data necessary to be evaluated and informed consent, 317 subjects were included to the DAPA group and 288 to the SOC group. Both categorical and continuous variables were analysed and compared with the usual statistics. Cohen's d was used to assess the standardised difference in means.

Results: Six hundred and five patients with T2D were assessed (mean age 63.5 [SD±8.1] years, 61.8% men), whom 17.4% were smokers, 47.6% had obesity, 74.8% hypertension, 87.3% dyslipidaemia, and 41.7% reported physical inactivity, with no significant differences between both comparison groups. The mean (SD) evolution time of T2D was 10.1 (5.6) years. Most baseline clinical-biological characteristics at recruitment were similar in both groups. However, DAPA group was younger (2.9 years), and had lower systolic blood pressure (SBP) (2.8mmHg), higher body weight (BW) (3.7kg), and higher glycated haemoglobin A1c (HbA1c) (0.3%) than SOC group. Only 11.5% of participants had poor glycaemic control (HbA1c>8%) at recruitment, 54.9% had good glycaemic control (HbA1c<7%), being significantly lower in the DAPA group (47.3%) than in the SOC group (63.4%). The percentage of T2D patients with high vascular risk (VR) was 46.3%, and 53.7% with very high VR, being significantly higher in the DAPA group (57.4%) than in the SOC group (49.6%).

Conclusions: Most baseline cardiovascular-kidney-metabolic characteristics were similar in T2D patients whom had added dapagliflozin on second-line hypoglycaemic therapy as those whom had added-on another OGLD. However, patients whom had added-on dapagliflozin had higher VR, lower SBP, higher BW, and slightly worse HbA1c control. Future research is necessary to explain the causes of these differences in cardiometabolic control.

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来源期刊
Clinica e Investigacion en Arteriosclerosis
Clinica e Investigacion en Arteriosclerosis PERIPHERAL VASCULAR DISEASE-
CiteScore
3.20
自引率
6.20%
发文量
44
审稿时长
40 days
期刊介绍: La publicación idónea para acceder tanto a los últimos originales de investigación como a formación médica continuada sobre la arteriosclerosis y su etiología, epidemiología, fisiopatología, diagnóstico y tratamiento. Además, es la publicación oficial de la Sociedad Española de Arteriosclerosis.
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