目的:利格列汀和维格列汀的不同作用可能有助于我们个性化治疗2型糖尿病(T2DM)。当前的研究在人工神经网络(ANN)模型中比较了这些药物对糖化血红蛋白(HbA1c)的影响。
方法:接受维格列汀或利格列汀治疗的T2DM患者,使用预定义的排除标准,有资格参加这项研究。构建了两个输入变量数据集:有或没有缺失值的填补。主要结果是3至12个月之间的HbA1c读数或HbA1c水平降低。
结果:该队列包括191名个体(92名维格列汀和99名利格列汀)。利格列汀组的疾病负担明显较高。对于估算的数据集,利格列汀在3至12个月时HbA1c较低(7.442±0.408vs.7.626±0.408,P<0.001)。然而,在HbA1c降低方面,维格列汀优于利格列汀(-1.123±0.033vs.-1.111±0.043,P<0.001)。LDL水平,尿酸,药物组被确定为HbA1c水平的预测因子。在非估算数据集中,利格列汀在3至12个月时HbA1c较低(中位数±IQR:7.489±0.467与7.634±0.467,P值<0.001)。然而,利格列汀和维格列汀的HbA1c水平降低相似(中位数±IQR均为-1.07±0.02).HbA1c水平的预测因子包括eGFR水平和药物组。
结论:利格列汀比维格列汀更有效地降低HbA1c水平,包括有合并症的患者。DPP4-I选择是所有模型中HbA1c的恒定预测因子。
OBJECTIVE: Differential effects of linagliptin and
vildagliptin may help us personalize treatment for Type 2 Diabetes Mellitus (T2DM). The current study compares the effect of these drugs on glycated hemoglobin (HbA1c) in an artificial neural network (ANN) model.
METHODS: Patients with T2DM who received either
vildagliptin or linagliptin, with predefined exclusion criteria, qualified for the study. Two input variable datasets were constructed: with or without imputation for missing values. The primary outcome was HbA1c readings between 3 to 12 months or the reduction in HbA1c levels.
RESULTS: The cohort comprised 191 individuals (92
vildagliptin and 99 linagliptin). Linagliptin group had significantly higher disease burden. For imputed dataset, HbA1c was lower with linagliptin at 3 to 12 months (7.442 ± 0.408 vs. 7.626 ± 0.408, P < 0.001). However, there was a small yet significant difference in HbA1c reduction favoring vildagliptin over linagliptin (-1.123 ± 0.033 vs. -1.111 ± 0.043, P < 0.001). LDL level, uric acid, and the drug group were identified as predictors for HbA1c levels. In the non-imputed dataset HbA1c at 3 to 12 months was lower with linagliptin (median ± IQR: 7.489 ± 0.467 vs. 7.634 ± 0.467, P-value < 0.001). However, both linagliptin and
vildagliptin exhibited similar reductions in HbA1c levels (both median ± IQR of -1.07 ± 0.02). Predictors for HbA1c levels included eGFR level and the drug group.
CONCLUSIONS: Linagliptin effectively lowers HbA1c levels more than
vildagliptin including in patients with comorbidities. DPP4-I choice is a constant predictor of HbA1c in all models.