Diabetes Metab J.  2014 Jun;38(3):211-219. 10.4093/dmj.2014.38.3.211.

The Effect of DPP-4 Inhibitors on Metabolic Parameters in Patients with Type 2 Diabetes

• Choe EY
• Cho Y
• Choi Y
• Yun Y
• Wang HJ
• Kwon O
• Lee BW
• Ahn CW
• Cha BS
• Lee HC
• Kang ES

• KMID: 2280692
• DOI: http://doi.org/10.4093/dmj.2014.38.3.211

Abstract

BACKGROUND
We evaluated the effects of two dipeptidyl peptidase-4 (DPP-4) inhibitors, sitagliptin and vildagliptin, on metabolic parameters in patients with type 2 diabetes mellitus.
METHODS
A total of 170 type 2 diabetes patients treated with sitagliptin or vildagliptin for more than 24 weeks were selected. The patients were separated into two groups, sitagliptin (100 mg once daily, n=93) and vildagliptin (50 mg twice daily, n=77). We compared the effect of each DPP-4 inhibitor on metabolic parameters, including the fasting plasma glucose (FPG), postprandial glucose (PPG), glycated hemoglobin (HbA1c), and glycated albumin (GA) levels, and lipid parameters at baseline and after 24 weeks of treatment.
RESULTS
The HbA1c, FPG, and GA levels were similar between the two groups at baseline, but the sitagliptin group displayed a higher PPG level (P=0.03). After 24 weeks of treatment, all of the glucose-related parameters were significantly decreased in both groups (P=0.001). The levels of total cholesterol and triglycerides were only reduced in the vildagliptin group (P=0.001), although the sitagliptin group received a larger quantity of statins than the vildagliptin group (P=0.002).The mean change in the glucose- and lipid-related parameters after 24 weeks of treatment were not significantly different between the two groups (P=not significant). Neither sitagliptin nor vildagliptin treatment was associated with a reduction in the high sensitive C-reactive protein level (P=0.714).
CONCLUSION
Vildagliptin and sitagliptin exert a similar effect on metabolic parameters, but vildagliptin exerts a more potent beneficial effect on lipid parameters.

Keyword

Diabetes mellitus; DPP-4 inhibitor; Glycated serum albumin; Lipids

MeSH Terms

Blood Glucose
C-Reactive Protein
Cholesterol
Diabetes Mellitus
Diabetes Mellitus, Type 2
Fasting
Glucose
Hemoglobin A, Glycosylated
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Triglycerides
Sitagliptin Phosphate
C-Reactive Protein
Cholesterol
Glucose
Triglycerides

Figure

• 

  Fig. 1 (A-F) Change in the metabolic parameters during dipeptidyl peptidase-4 (DPP-4) inhibitor treatment. Values are presented as mean±standard error. SITA, sitagliptin; VILDA, vildagliptin; GA, glycated albumin; HbA1c, glycated hemoglobin; FPG, fasting plasma glucose; PPG, postprandial glucose. aP<0.05, compared to baseline.

• 

  Fig. 2 (A-D) Proportion of subjects that reached the target glucose range. Student t-test was performed. SITA, sitagliptin; VILDA, vildagliptin; HbA1c, glycated hemoglobin; ΔHbA1c ≥1, greater than 1% decrease in the HbA1c level from baseline; GA, glycated albumin; ΔGA ≥3, greater than 3% decrease in the GA level from baseline.

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