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Sitagliptin improves albuminuria in patients with type 2 diabetes mellitus.

Mori H, Okada Y, Arao T, Tanaka Y - J Diabetes Investig (2013)

Bottom Line: A total of 15 patients with albuminuria showed a reduction in urinary albumin excretion, suggesting the beneficial effect of sitagliptin in the early stage of diabetic nephropathy.The results suggested that sitagliptin improved albuminuria, in addition to improving glucose.The mechanism of the reduction of albuminuria by sitagliptin could be a direct effect, as well as an increase in active glucagon-like peptide-1, independently affecting blood pressure, bodyweight and glucose metabolism.

View Article: PubMed Central - PubMed

Affiliation: First Department of Internal Medicine School of Medicine University of Occupational and Environmental Health Kitakyushu Japan.

ABSTRACT

Introduction: The aim of the present study was to determine the effect of sitagliptin on microalbuminuria in patients with type 2 diabetes mellitus.

Materials and methods: A total of 85 patients with type 2 diabetes mellitus (age >20 years, <80 years, hemoglobin A1c [HbA1c] <8.4%) were randomized to patients taking sitagliptin 50 mg or other oral glucose-lowering agents. The following parameters were evaluated at 0, 3 and 6 months after the treatment: bodyweight, blood pressure, HbA1c, fasting plasma glucose, fasting plasma insulin, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, estimated glomerular filtration rate and urinary albumin excretion. The primary outcome was changes in urinary albumin excretion at 6 months.

Results: Significant and comparable falls in HbA1c and fasting plasma glucose were found in both groups. However, sitagliptin significantly reduced urinary albumin excretion within 6 months, especially in patients with high urinary albumin at baseline. A total of 27 patients with normoalbuminuria showed a reduction in urinary albumin excretion, suggesting that sitagliptin prevents the development of albuminuria. A total of 15 patients with albuminuria showed a reduction in urinary albumin excretion, suggesting the beneficial effect of sitagliptin in the early stage of diabetic nephropathy. There was a significant correlation between improvement of proteinuria and that of diastolic blood pressure.

Conclusions: The results suggested that sitagliptin improved albuminuria, in addition to improving glucose. The mechanism of the reduction of albuminuria by sitagliptin could be a direct effect, as well as an increase in active glucagon-like peptide-1, independently affecting blood pressure, bodyweight and glucose metabolism. This trial was registered with the University Hospital Medical Information Network (UMIN no. #000010871).

No MeSH data available.


Related in: MedlinePlus

(a) Effects of 6‐month course of sitagliptin on log urinary albumin excretion in subgroups of patients with high (≥30 mg/gCre) and low (<30 mg/gCre) urinary albumin excretion levels. Baseline and post‐treatment values within each group were compared by Friedman test. (b) Mean percentage change in log urinary albumin excretion in subgroups of patients with high (≥30 mg/gCre) and low (<30 mg/gCre) urinary albumin excretion levels. Between‐group comparisons were tested by unpaired Mann–Whitney U‐test. Data are presented as box and whisker plots.
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jdi12142-fig-0002: (a) Effects of 6‐month course of sitagliptin on log urinary albumin excretion in subgroups of patients with high (≥30 mg/gCre) and low (<30 mg/gCre) urinary albumin excretion levels. Baseline and post‐treatment values within each group were compared by Friedman test. (b) Mean percentage change in log urinary albumin excretion in subgroups of patients with high (≥30 mg/gCre) and low (<30 mg/gCre) urinary albumin excretion levels. Between‐group comparisons were tested by unpaired Mann–Whitney U‐test. Data are presented as box and whisker plots.

Mentions: We also divided the sitagliptin group into two subgroups according to the baseline urinary albumin excretion level, using a cut‐off level of 30.0 mg/gCre. A reduction in log urinary albumin excretion was observed at 3 months (from 2.0 ± 0.4 to 1.7 ± 0.5) and at 6 months (to 1.5 ± 0.7) in the ≥30 mg/gCre group (P = 0.001), and, at 3 months (from 0.9 ± 0.3 to 0.7 ± 0.4) and at 6 months (to 0.7 ± 0.3) in the <30 mg/gCre group (P < 0.0001). The decrease in urinary albumin excretion was significant in both groups (Figure 2a). There were no significant differences between the two subgroups in the percentage changes in log urinary albumin excretion (Figure 2b).


Sitagliptin improves albuminuria in patients with type 2 diabetes mellitus.

Mori H, Okada Y, Arao T, Tanaka Y - J Diabetes Investig (2013)

(a) Effects of 6‐month course of sitagliptin on log urinary albumin excretion in subgroups of patients with high (≥30 mg/gCre) and low (<30 mg/gCre) urinary albumin excretion levels. Baseline and post‐treatment values within each group were compared by Friedman test. (b) Mean percentage change in log urinary albumin excretion in subgroups of patients with high (≥30 mg/gCre) and low (<30 mg/gCre) urinary albumin excretion levels. Between‐group comparisons were tested by unpaired Mann–Whitney U‐test. Data are presented as box and whisker plots.
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Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4020336&req=5

jdi12142-fig-0002: (a) Effects of 6‐month course of sitagliptin on log urinary albumin excretion in subgroups of patients with high (≥30 mg/gCre) and low (<30 mg/gCre) urinary albumin excretion levels. Baseline and post‐treatment values within each group were compared by Friedman test. (b) Mean percentage change in log urinary albumin excretion in subgroups of patients with high (≥30 mg/gCre) and low (<30 mg/gCre) urinary albumin excretion levels. Between‐group comparisons were tested by unpaired Mann–Whitney U‐test. Data are presented as box and whisker plots.
Mentions: We also divided the sitagliptin group into two subgroups according to the baseline urinary albumin excretion level, using a cut‐off level of 30.0 mg/gCre. A reduction in log urinary albumin excretion was observed at 3 months (from 2.0 ± 0.4 to 1.7 ± 0.5) and at 6 months (to 1.5 ± 0.7) in the ≥30 mg/gCre group (P = 0.001), and, at 3 months (from 0.9 ± 0.3 to 0.7 ± 0.4) and at 6 months (to 0.7 ± 0.3) in the <30 mg/gCre group (P < 0.0001). The decrease in urinary albumin excretion was significant in both groups (Figure 2a). There were no significant differences between the two subgroups in the percentage changes in log urinary albumin excretion (Figure 2b).

Bottom Line: A total of 15 patients with albuminuria showed a reduction in urinary albumin excretion, suggesting the beneficial effect of sitagliptin in the early stage of diabetic nephropathy.The results suggested that sitagliptin improved albuminuria, in addition to improving glucose.The mechanism of the reduction of albuminuria by sitagliptin could be a direct effect, as well as an increase in active glucagon-like peptide-1, independently affecting blood pressure, bodyweight and glucose metabolism.

View Article: PubMed Central - PubMed

Affiliation: First Department of Internal Medicine School of Medicine University of Occupational and Environmental Health Kitakyushu Japan.

ABSTRACT

Introduction: The aim of the present study was to determine the effect of sitagliptin on microalbuminuria in patients with type 2 diabetes mellitus.

Materials and methods: A total of 85 patients with type 2 diabetes mellitus (age >20 years, <80 years, hemoglobin A1c [HbA1c] <8.4%) were randomized to patients taking sitagliptin 50 mg or other oral glucose-lowering agents. The following parameters were evaluated at 0, 3 and 6 months after the treatment: bodyweight, blood pressure, HbA1c, fasting plasma glucose, fasting plasma insulin, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, estimated glomerular filtration rate and urinary albumin excretion. The primary outcome was changes in urinary albumin excretion at 6 months.

Results: Significant and comparable falls in HbA1c and fasting plasma glucose were found in both groups. However, sitagliptin significantly reduced urinary albumin excretion within 6 months, especially in patients with high urinary albumin at baseline. A total of 27 patients with normoalbuminuria showed a reduction in urinary albumin excretion, suggesting that sitagliptin prevents the development of albuminuria. A total of 15 patients with albuminuria showed a reduction in urinary albumin excretion, suggesting the beneficial effect of sitagliptin in the early stage of diabetic nephropathy. There was a significant correlation between improvement of proteinuria and that of diastolic blood pressure.

Conclusions: The results suggested that sitagliptin improved albuminuria, in addition to improving glucose. The mechanism of the reduction of albuminuria by sitagliptin could be a direct effect, as well as an increase in active glucagon-like peptide-1, independently affecting blood pressure, bodyweight and glucose metabolism. This trial was registered with the University Hospital Medical Information Network (UMIN no. #000010871).

No MeSH data available.


Related in: MedlinePlus