Wani Javaid H, John-Kalarickal Jennifer, Fonseca Vivian A
Tulane University Health Sciences Center, 1430 Tulane Avenue, SL-53, New Orleans, LA 70112-2632, USA.
Cardiol Clin. 2008 Nov;26(4):639-48. doi: 10.1016/j.ccl.2008.06.008.
Type 2 diabetes mellitus is a metabolic disease leading to microvascular and macrovascular complications including coronary artery disease and stroke. Management of diabetes has been challenging, particularly in the presence of the enormous prevalence of obesity. In recent years, various inhibitors of the enzyme dipeptidyl peptidase (DPP)-4 have been developed to treat diabetes. The enzyme DPP-4 cleaves incretins, which, among other functions, stimulate insulin and suppresses glucagon. Inhibition of this enzyme results in an increase in the half-life and the sustained physiologic action of incretins, leading to an improvement in hyperglycemia. One such agent, namely sitagliptin (MK-04,310), has been introduced into the United States market, and another agent, vildagliptin (LAF237), is being used in Europe and elsewhere. This article is intended to evaluate the effectiveness of DPP-4 inhibitors as a therapeutic modality for managing type 2 diabetes. The authors conducted a literature search of various databases to identify the clinical trials involving the DPP inhibitors and concluded that the DPP-4 inhibitors, for example, sitagliptin and vildagliptin, are efficacious for managing diabetes as monotherapy or combination therapy.
2型糖尿病是一种代谢性疾病，可导致微血管和大血管并发症，包括冠状动脉疾病和中风。糖尿病的管理一直具有挑战性，尤其是在肥胖症患病率极高的情况下。近年来，已开发出各种二肽基肽酶（DPP）-4抑制剂来治疗糖尿病。DPP-4酶可切割肠促胰岛素，肠促胰岛素除其他功能外，还能刺激胰岛素分泌并抑制胰高血糖素分泌。抑制这种酶会导致肠促胰岛素的半衰期延长和生理作用持续，从而改善高血糖症。一种这样的药物，即西他列汀（MK-04310），已进入美国市场，另一种药物维格列汀（LAF237）正在欧洲和其他地区使用。本文旨在评估DPP-4抑制剂作为治疗2型糖尿病的一种治疗方式的有效性。作者对各种数据库进行了文献检索，以确定涉及DPP抑制剂的临床试验，并得出结论，DPP-4抑制剂，例如西他列汀和维格列汀，作为单一疗法或联合疗法治疗糖尿病是有效的。
