A comparison of effects of DPP-4 inhibitor and SGLT2 inhibitor on lipid profile in patients with type 2 diabetes.

Abstract

BACKGROUND:

Previous studies suggest that dipeptidyl peptidase-4 (DPP-4) inhibitors and sodium glucose cotransporter 2 (SGLT2) inhibitors have different effects on the lipid profile in patients with type 2 diabetes. We investigated the effects of DPP-4 inhibitors and SGLT2 inhibitors on the lipid profile in patients with type 2 diabetes.

METHODS:

From January 2013 to December 2015, a total of 228 patients with type 2 diabetes who were receiving a DPP-4 inhibitor or SGLT2 inhibitor as add-on therapy to metformin and/or a sulfonylurea were consecutively enrolled. We compared the effects of DPP-4 inhibitors and SGLT2 inhibitors on the lipid profile at baseline and after 24 weeks of treatment. To compare lipid parameters between the two groups, we used the analysis of covariance (ANCOVA).

RESULTS:

A total of 184 patients completed follow-up (mean age: 53.1 ± 6.9 years, mean duration of diabetes: 7.1 ± 5.7 years). From baseline to 24 weeks, HDL-cholesterol (HDL-C) levels were increased by 0.5 (95% CI, -0.9 to 2.0) mg/dl with a DPP-4 inhibitor and by 5.1 (95% CI, 3.0 to 7.1) mg/dl with an SGLT2 inhibitor (p = 0.001). LDL-cholesterol (LDL-C) levels were reduced by 8.4 (95% CI, -14.0 to -2.8) mg/dl with a DPP-4 inhibitor, but increased by 1.3 (95% CI, -5.1 to 7.6) mg/dl with an SGLT2 inhibitor (p = 0.046). There was no significant difference in the mean hemoglobin A1c (8.3 ± 1.1 vs. 8.0 ± 0.9%, p = 0.110) and in the change of total cholesterol (TC) (p = 0.836), triglyceride (TG) (p = 0.867), apolipoprotein A (p = 0.726), apolipoprotein B (p = 0.660), and lipoprotein (a) (p = 0.991) between the DPP-4 inhibitor and the SGLT2 inhibitor.

CONCLUSIONS:

The SGLT2 inhibitor was associated with a significant increase in HDL-C and LDL-C after 24 weeks of SGLT2 inhibitor treatment in patients with type 2 diabetes compared with those with DPP-4 inhibitor treatment in this study.

TRIAL REGISTRATION:

This study was conducted by retrospective medical record review.

• Authors: Seon-Ah Cha, Yong-Moon Park, Jae-Seung Yun, Tae-Seok Lim, Ki-Ho Song, Ki-Dong Yoo, Yu-Bae Ahn, Seung-Hyun Ko
• Journal: Lipids in health and disease (Lipids Health Dis) Vol. 16 Issue 1 Pg. 58 (Apr 13 2017) ISSN: 1476-511X [Electronic] England
• PMID: 28403877 (Publication Type: Comparative Study, Journal Article, Observational Study)

Chemical References

• Benzhydryl Compounds
• Dipeptidyl-Peptidase IV Inhibitors
• Glucosides
• Glycated Hemoglobin A
• LC15-0444
• Membrane Transport Modulators
• Piperidones
• Pyrimidines
• Sodium-Glucose Transporter 2
• Sodium-Glucose Transporter 2 Inhibitors
• hemoglobin A1c protein, human
• dapagliflozin
• Linagliptin

Topics

• Benzhydryl Compounds (adverse effects, therapeutic use)
• Cardiovascular Diseases (complications, epidemiology, prevention & control)
• Diabetes Mellitus, Type 2 (blood, complications, drug therapy, metabolism)
• Diabetic Angiopathies (epidemiology, prevention & control)
• Diabetic Cardiomyopathies (epidemiology, prevention & control)
• Dipeptidyl-Peptidase IV Inhibitors (adverse effects, therapeutic use)
• Drug Therapy, Combination (adverse effects)
• Female
• Follow-Up Studies
• Glucosides (adverse effects, therapeutic use)
• Glycated Hemoglobin (analysis)
• Humans
• Hyperglycemia (prevention & control)
• Hyperlipidemias (complications, epidemiology, prevention & control)
• Linagliptin (adverse effects, therapeutic use)
• Male
• Membrane Transport Modulators (adverse effects, therapeutic use)
• Middle Aged
• Piperidones (adverse effects, therapeutic use)
• Pyrimidines (adverse effects, therapeutic use)
• Republic of Korea (epidemiology)
• Retrospective Studies
• Risk Factors
• Sodium-Glucose Transporter 2 (metabolism)
• Sodium-Glucose Transporter 2 Inhibitors