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Impact of dipeptidyl peptidase-4 inhibitors on serum adiponectin: a meta-analysis

View Article: PubMed Central - PubMed

ABSTRACT

Background: Adiponectin, an adipose-specific protein, is negatively correlated with pro-atherogenic low-density lipoprotein cholesterol (LDL-C) and other cardiovascular risk factors such as insulin resistance. Therefore, low levels of adiponectin are associated with a higher risk for diabetes and cardiovascular disease. Dipeptidyl peptidase-4 inhibitors (DPP4i) have been used for the treatment of type 2 diabetes mellitus (T2DM) as reversible inhibitors through interacting with DPP4 substrate and increase serum incretins such as glucagon-like peptide-1 (GLP-1). The present study aimed to evaluate the effect of DPP4i on serum adiponectin in T2DM patients.

Methods: The PubMed, Embase, and Cochrane library databases were searched from inception to February 2016. Randomized controlled trials, evaluating the DPP4i (sitagliptin and vildagliptin) versus comparator (placebo or active-comparison), in T2DM patients with duration of ≥ 12 weeks, were identified. Weighted differences in means of adiponectin levels were calculated by using a fixed or random-effects model.

Results: Ten randomized controlled trials, including 1,495 subjects, were identified. Compared with placebo, DPP4i (sitagliptin and vildagliptin) treatment significantly elevated adiponectin levels by 0.74 μg/mL (95% confidence interval [CI], 0.45 to 1.03) relative to that using an active-comparison by 0.00 μg/mL (95% CI, −0.57 to 0.56). Compared with active-comparison, vildagliptin treatment increased adiponectin levels by 0.32 μg/mL (95% CI, −0.01 to 0.65), whereas sitagliptin treatment decreased adiponectin levels by −0.24 μg/mL (95% CI, −1.07 to 0.58). Trials examining effects of other DPP4i were not found.

Conclusions: Sitagliptin and vildagliptin increased serum adiponectin levels and had no stronger effect than traditional oral antidiabetic drugs. Further trials with larger sample size are needed to confirm the results and investigate the association between serum adiponectin levels and treatment of other DPP-4 inhibitors.

Trial registration: Registration No in PROSPERO: CRD42016037399.

No MeSH data available.


Flow chart of studies included in the meta-analysis
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Fig1: Flow chart of studies included in the meta-analysis

Mentions: Initially, 11,885 citations were found to meet the inclusion criteria. A study inclusion flowchart was presented in Fig. 1. After removal of inappropriate studies, ten randomized controlled trials including 1,495 subjects were identified, four studies were performed in Italy, one in Germany, and five in Japan. Characteristics of the 10 intervention studies are shown in Table 1. Trial quality was evaluated by using the Cochrane risk of bias tool (Fig. 2). Five studies fully fit the seven factors. Two studies were adequate for six of the seven factors, one study was adequate for five of the seven factors and two studies were adequate for four of the seven factors.Fig. 1


Impact of dipeptidyl peptidase-4 inhibitors on serum adiponectin: a meta-analysis
Flow chart of studies included in the meta-analysis
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC5120528&req=5

Fig1: Flow chart of studies included in the meta-analysis
Mentions: Initially, 11,885 citations were found to meet the inclusion criteria. A study inclusion flowchart was presented in Fig. 1. After removal of inappropriate studies, ten randomized controlled trials including 1,495 subjects were identified, four studies were performed in Italy, one in Germany, and five in Japan. Characteristics of the 10 intervention studies are shown in Table 1. Trial quality was evaluated by using the Cochrane risk of bias tool (Fig. 2). Five studies fully fit the seven factors. Two studies were adequate for six of the seven factors, one study was adequate for five of the seven factors and two studies were adequate for four of the seven factors.Fig. 1

View Article: PubMed Central - PubMed

ABSTRACT

Background: Adiponectin, an adipose-specific protein, is negatively correlated with pro-atherogenic low-density lipoprotein cholesterol (LDL-C) and other cardiovascular risk factors such as insulin resistance. Therefore, low levels of adiponectin are associated with a higher risk for diabetes and cardiovascular disease. Dipeptidyl peptidase-4 inhibitors (DPP4i) have been used for the treatment of type 2 diabetes mellitus (T2DM) as reversible inhibitors through interacting with DPP4 substrate and increase serum incretins such as glucagon-like peptide-1 (GLP-1). The present study aimed to evaluate the effect of DPP4i on serum adiponectin in T2DM patients.

Methods: The PubMed, Embase, and Cochrane library databases were searched from inception to February 2016. Randomized controlled trials, evaluating the DPP4i (sitagliptin and vildagliptin) versus comparator (placebo or active-comparison), in T2DM patients with duration of ≥ 12 weeks, were identified. Weighted differences in means of adiponectin levels were calculated by using a fixed or random-effects model.

Results: Ten randomized controlled trials, including 1,495 subjects, were identified. Compared with placebo, DPP4i (sitagliptin and vildagliptin) treatment significantly elevated adiponectin levels by 0.74 μg/mL (95% confidence interval [CI], 0.45 to 1.03) relative to that using an active-comparison by 0.00 μg/mL (95% CI, −0.57 to 0.56). Compared with active-comparison, vildagliptin treatment increased adiponectin levels by 0.32 μg/mL (95% CI, −0.01 to 0.65), whereas sitagliptin treatment decreased adiponectin levels by −0.24 μg/mL (95% CI, −1.07 to 0.58). Trials examining effects of other DPP4i were not found.

Conclusions: Sitagliptin and vildagliptin increased serum adiponectin levels and had no stronger effect than traditional oral antidiabetic drugs. Further trials with larger sample size are needed to confirm the results and investigate the association between serum adiponectin levels and treatment of other DPP-4 inhibitors.

Trial registration: Registration No in PROSPERO: CRD42016037399.

No MeSH data available.