A clinical score to predict dose reductions of antidiabetes medications with intentional weight loss: A retrospective cohort study

被引:1
作者
Shantha, Ghanshyam Palamaner Subash [1 ,2 ]
Kumar, Anita Ashok [2 ]
Ravi, Vimal [3 ]
Khanna, Rohit C. [4 ]
Kahan, Scott [5 ,6 ]
Cheskin, Lawrence J. [7 ,8 ,9 ,10 ]
机构
[1] Univ Iowa Hosp & Clin, Div Cardiovasc Med, Iowa City, IA 52242 USA
[2] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA
[3] Wright Ctr Grad Med Educ, Dept Internal Med, Scranton, PA USA
[4] LV Prasad Eye Inst, Div Community Ophthalmol, Allen Foster Res Ctr Community Eye Hlth, Int Ctr Adv Rural Eye Care, Hyderabad, Andhra Pradesh, India
[5] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Hlth Policy & Management, Baltimore, MD USA
[6] George Washington Univ, Sch Publ Hlth & Hlth Serv, Dept Hlth Policy, Washington, DC USA
[7] Johns Hopkins Univ, Johns Hopkins Weight Management Ctr, Baltimore, MD USA
[8] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Hlth Behav & Soc, Baltimore, MD USA
[9] Johns Hopkins Univ, Global Obes Prevent Ctr, Baltimore, MD USA
[10] Johns Hopkins Univ, Int Hlth Human Nutr, Bloomberg Sch Publ Hlth, Baltimore, MD USA
关键词
Clinical score; Diabetes mellitus; Insulin resistance; Obesity; GASTRIC BYPASS-SURGERY; OBESITY; PREVALENCE; TRIAL; RISK;
D O I
10.1016/j.bj.2016.06.002
中图分类号
Q5 [生物化学]; Q7 [分子生物学];
学科分类号
071010 ; 081704 ;
摘要
Background: We assessed the predictive accuracy of an empirically-derived score (weight loss, insulin resistance, and glycemic control: "WIG") to predict patients who will be successful in reducing diabetes mellitus (DM) medication use with weight loss. Methods: Case records of 121 overweight and obese patients with DM at two outpatient weight management centers were analyzed. Results: Mean period of follow-up was 12.5 +/- 3.5 months. To derive the "WIG" scoring algorithm, one point each was assigned to "W" (loss of 5% of initial body weight within the first 3 months of attempting weight loss), "I" (triglyceride [TGL]/highdensity lipoprotein ratio >3 [marker of insulin resistance] at baseline), and "G" (glycosylated hemoglobin [A1c %] >8.5 at baseline). WIG score showed moderate accuracy in discriminating anti-DM dose reductions at baseline, and after 3 months of weight loss efforts (likelihood ratios [LR] + >1, LR - <1, and area under the curve >0.7), and demonstrated good reproducibility. Conclusions: WIG score shows promise as a tool to predict success with dose reductions of antidiabetes medications.
引用
收藏
页码:188 / 194
页数:7
相关论文
共 23 条
  • [1] Comparative Effectiveness of Weight-Loss Interventions in Clinical Practice
    Appel, Lawrence J.
    Clark, Jeanne M.
    Yeh, Hsin-Chieh
    Wang, Nae-Yuh
    Coughlin, Janelle W.
    Daumit, Gail
    Miller, Edgar R., III
    Dalcin, Arlene
    Jerome, Gerald J.
    Geller, Steven
    Noronha, Gary
    Pozefsky, Thomas
    Charleston, Jeanne
    Reynolds, Jeffrey B.
    Durkin, Nowella
    Rubin, Richard R.
    Louis, Thomas A.
    Brancati, Frederick L.
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 2011, 365 (21) : 1959 - 1968
  • [2] Economic costs of obesity and inactivity
    Colditz, GA
    [J]. MEDICINE AND SCIENCE IN SPORTS AND EXERCISE, 1999, 31 (11) : S663 - S667
  • [3] COMPARING THE AREAS UNDER 2 OR MORE CORRELATED RECEIVER OPERATING CHARACTERISTIC CURVES - A NONPARAMETRIC APPROACH
    DELONG, ER
    DELONG, DM
    CLARKEPEARSON, DI
    [J]. BIOMETRICS, 1988, 44 (03) : 837 - 845
  • [4] Espeland M, 2007, DIABETES CARE, V30, P1374
  • [5] Risk score for prediction of 10 year dementia risk in individuals with type 2 diabetes: a cohort study
    Exalto, Lieza G.
    Biessels, Geert Jan
    Karter, Andrew J.
    Huang, Elbert S.
    Katon, Wayne J.
    Minkoff, Jerome R.
    Whitmer, Rachel A.
    [J]. LANCET DIABETES & ENDOCRINOLOGY, 2013, 1 (03) : 183 - 190
  • [6] Diabetes, lipids, and adipocyte secretagogues
    Faraj, M
    Lu, HL
    Cianflone, K
    [J]. BIOCHEMISTRY AND CELL BIOLOGY, 2004, 82 (01) : 170 - 190
  • [7] Prevalence of Obesity and Trends in the Distribution of Body Mass Index Among US Adults, 1999-2010
    Flegal, Katherine M.
    Carroll, Margaret D.
    Kit, Brian K.
    Ogden, Cynthia L.
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2012, 307 (05): : 491 - 497
  • [8] Flier JS., 2005, HARRISONS PRINCIPLES, V1, P422
  • [9] Gonzalez-Chavez Antonio, 2011, Cir Cir, V79, P126
  • [10] Greenberg RS., 2005, MED EPIDEMIOLOGY, VFourth