TITLE:
Switching from Sitagliptin to Alogliptin under Treatment with Pioglitazone Increases High Molecular Weight Adiponectin in Type 2 Diabetes: A Prospective Observational Study
AUTHORS:
Akinori Tokito, Nobuyuki Koriyama, Ayako Ijuin, Kazuma Ogiso, Yoshihiko Nishio, Michihisa Jougasaki
KEYWORDS:
Alogliptin, Dipeptidyl Peptidase-4 Inhibitor, High Molecular Weight Adiponectin, Type 2 Diabetes
JOURNAL NAME:
Journal of Diabetes Mellitus,
Vol.5 No.4,
October
30,
2015
ABSTRACT: Background: There are few clinical trials addressing the difference in
pleiotropic effects among dipeptidyl peptidase (DPP)-4 inhibitors. We aimed to
identify difference in effects on biochemical markers of inflammation,
oxidative stress, and atherosclerosis between two DPP-4 inhibitors in patients
with type 2 diabetes. Methods: We prospectively observed twenty subjects with
type 2 diabetes before and after a practical medication change from a treatment
with pioglitazone and sitagliptin 50 mg to a combination tablet containing the
same dose of pioglitazone and alogliptin 25mg, which was actually identical to
switching from sitagliptin to alogliptin. After 3 months, changes from baseline
in clinical data and various biochemical markers were evaluated. In particular,
body mass index (BMI) and hemoglobin A1c (HbA1c) were additionally followed
after 12 months for evaluation of chronic outcomes. Results: Among markers,
serum levels of high molecular weight (HMW) adiponectin significantly increased
from 6.9 ± 3.6 μg/ml to 8.2 ± 4.0 μg/ml (P = 0.0045). Although no clinical data changed after 3 months, significant
improvements in HbA1c and BMI were observed after 12 months. Their rates of
changes tended to inversely correlate with the increased percentages of serum
HMW adiponectin levels during initial 3 months, but they did not reach statistical significance. Conclusions: In
spite of pretreatment with pioglitazone, additional increase in serum
HMW adiponectin levels was demonstrated after switching from sitagliptin to alogliptin. Given multiple favorable roles
of adiponectin in metabolic and cardiovascular states, alogliptin, at
least when combined with pioglitazone, would be beneficial in treatment of type
2 diabetes.