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首页> 外文期刊>Endocrinology, Diabetes & Metabolism >Course of body weight before and after the initiation of insulin therapy in type 2 diabetes mellitus: Retrospective inception cohort study (ZODIAC 58)
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Course of body weight before and after the initiation of insulin therapy in type 2 diabetes mellitus: Retrospective inception cohort study (ZODIAC 58)

机译：在2型糖尿病胰岛素治疗前后的体重疗程：回顾性初始队列研究（黄道带58）

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Aims The aim of this study was to explore the effect of insulin treatment initiation on weight by taking weight change prior to initiation into account. Materials and methods We performed an observational retrospective inception cohort study, concerning Dutch primary care. We identified all patients that initiated insulin treatment ( n =?7967) and individually matched patients with a reference patient ( n =?5213 pairs). We obtained estimated mean weight changes in the five years prior to five years post insulin therapy. We applied linear regression analysis on weight change in the first year after insulin therapy (T0 to T+1), with matched group as primary determinant adjusted for pre‐insulin weight change and additional covariates. Results Estimated mean weight increased in the five consecutive years prior to insulin therapy (?0.23?kg in year T‐5 to T‐4, 0.01?kg in year T‐4 to T‐3, 0.07?kg in year T‐3 to T‐2, 0.24?kg in year T‐2 to T‐1, and 0.46?kg in year T‐1 to T0) and continued to increase in the first year after, that is T0 to T+1, at a slightly lower rate (0.31?±?3.9?kg). Pre‐insulin weight change had the highest explained variance and was inversely and independently associated with weight change (p??.001). Starting insulin was associated with weight increase, independent of pre‐insulin weight change (β‐adjusted 1.228, p??.001). Stratification revealed that despite having a more or less similar baseline BMI, patients with substantial weight increase showed higher estimated mean BMI’s followed by weight loss pre‐insulin. In matched references, estimated mean weight changes were negative in all years concerning the study period, indicating consistent weight loss. Conclusions Initiation of insulin therapy was independently associated with weight increase; however, overall effect on weight was small and subject to substantial variation. Pre‐insulin weight change is identified as a relatively strong inverse determinant of weight change after insulin initiation.
机译：目的这项研究的目的是通过在入发前进行体重变化来探讨胰岛素治疗开始对重量的影响。我们对荷兰初级保健进行了观察回顾性研究队列研究的材料和方法。我们鉴定了所有引发胰岛素治疗的患者（n =Δ7967）和单独匹配的参考患者患者（n =Δ5213对）。在胰岛素治疗后五年前五年，我们获得了估计的平均体重变化。我们在胰岛素治疗（T0至T + 1）后的第一年对重量变化的线性回归分析（T0至T + 1），匹配组作为胰岛素素重量变化和额外的协变量调整的主要决定因素。结果估计平均重量在胰岛素治疗前连续五年增加（T-5至T-4的0.23 kg，在T-4至T-3年为0.01Ω，0.07？Kg年度T-3在T-2到T-1年至T-1的T-2，0.24 kg，0.46 kg在T-1到T0中），并在第一年继续增加，即T0至T + 1，在a略低率（0.31？±3.9 kg）。前胰岛素重量变化具有最高的解性方差，与重量变化相反，与重量变化相比（p≤001）。起始胰岛素与重量增加相关，与胰岛素素重量变化无关（β-调节的1.228，p≤001）。分层显示，尽管具有或多或少类似的基线BMI，但重量增加的患者显示出更高的估计平均BMI，其次是减肥前胰岛素。在匹配的参考文献中，估计的平均体重变化在研究期间的所有年内都是阴性的，表明一致减肥。结论胰岛素治疗的启动与体重增加有关;然而，对重量的总体效果很小并且受到大量变化的影响。胰岛素引发后，鉴定胰岛素重量变化是相对强的重量变化的相对较强的逆确定性。

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