Del Prato S
Department of Endocrinology & Metabolism, Section of Metabolic Diseases and Diabetes University of Pisa, Pisa, Italy.
Int J Clin Pract Suppl. 2007 Aug(154):38-48. doi: 10.1111/j.1742-1241.2007.01439.x.
Dipeptidyl peptidase 4 (DPP-4) inhibition prevents the rapid degradation of the incretins, glucagon-like peptide 1 and glucose-dependent insulinotropic peptide. Incretins have beneficial effects on glycaemic control in patients with type 2 diabetes through their effects on both alpha- and beta-cells in the pancreas and possibly through additional non-pancreatic effects. Vildagliptin is a potent and selective oral DPP-4 inhibitor that has been studied both as monotherapy and in combination with other antidiabetic treatments. This agent has been shown to be well tolerated and is efficacious in reducing glycosylated haemoglobin, fasting plasma glucose and postprandial glucose levels in trials lasting up to 52 weeks. Vildagliptin is weight neutral, does not cause oedema and is associated with a very low incidence of hypoglycaemia. Recently reported clinical data have helped to further clarify the mechanisms of action and effects of vildagliptin. These results suggest that vildagliptin, as a member of the novel class of DPP-4 inhibitors, has the potential to significantly change the clinical management of diabetes. Future research will further define its use in various patient populations and its possible disease-modifying effects.
二肽基肽酶4（DPP-4）抑制剂可防止肠促胰岛素、胰高血糖素样肽1和葡萄糖依赖性促胰岛素多肽的快速降解。肠促胰岛素通过对胰腺中的α细胞和β细胞发挥作用，并可能通过其他非胰腺作用，对2型糖尿病患者的血糖控制产生有益影响。维格列汀是一种强效、选择性口服DPP-4抑制剂，已作为单一疗法以及与其他抗糖尿病治疗联合使用进行了研究。在长达52周的试验中，该药物已显示出耐受性良好，并且在降低糖化血红蛋白、空腹血糖和餐后血糖水平方面有效。维格列汀对体重无影响，不会引起水肿，且低血糖发生率极低。最近报道的临床数据有助于进一步阐明维格列汀的作用机制和效果。这些结果表明，作为新型DPP-4抑制剂类别的一员，维格列汀有可能显著改变糖尿病的临床管理。未来的研究将进一步确定其在不同患者群体中的应用及其可能的疾病改善作用。
