Shigematsu Erina, Yamakawa Tadashi, Kadonosono Kazuaki, Terauchi Yasuo
Department of Endocrinology and Diabetes, Yokohama City University Medical Center, Yokohama, Japan.
Department of Ophthalmology, Yokohama City University Medical Center, Yokohama, Japan.
J Clin Med Res. 2014 Oct;6(5):327-35. doi: 10.14740/jocmr1889w. Epub 2014 Jul 28.
Animal studies have demonstrated that an inhibition of DPP-4 has an impact on the secretion of cholesterol and apoB by the small intestine. However, there is no consensus about the changes of the lipid profile following administration of sitagliptin.
Accordingly, we treated patients who had type 2 diabetes complicated by dyslipidemia with sitagliptin and evaluated its effects on the profile of lipid parameters. A total of 248 outpatients with type 2 diabetes complicated by dyslipidemia were treated with sitagliptin at a daily dose of 50 mg. The levels and percent changes of lipid and glucose metabolism markers were measured at baseline and at 12 weeks after the initiation of treatment.
Both plasma glucose and HbA1c were significantly decreased. Among the lipid parameters, total cholesterol (TC) and non-high-density lipoprotein cholesterol (non-HDL-C) showed a significant decrease (TC 3.6±15.6%, non-HDL-C 2.9±19.7%; P < 0.05). Stratified analysis revealed a significant decrease of TC, low-density lipoprotein cholesterol (LDL-C) and non-HDL-C in the high triglyceride (TG) group (≥ 150 mg/dL) (P < 0.05). Analysis stratified by demographic factors demonstrated significant differences in the changes of TC, LDL-C and non-HDL-C. Multivariate analysis showed a significant decrease of the TC, LDL-C and non-HDL-C levels in the high TG group (≥ 150 mg/dL), as well as a significant decrease of TC and LDL-C in patients using strong statins.
The results suggested that sitagliptin caused a significant decrease of TC, LDL-C and non-HDL-C, particularly in patients with high baseline TG levels and those using strong statins.
动物研究表明，抑制二肽基肽酶-4（DPP-4）会影响小肠胆固醇和载脂蛋白B的分泌。然而，关于西格列汀给药后血脂谱的变化尚无共识。
因此，我们对2型糖尿病合并血脂异常的患者使用西格列汀进行治疗，并评估其对血脂参数谱的影响。总共248例2型糖尿病合并血脂异常的门诊患者接受了每日50 mg剂量的西格列汀治疗。在基线和治疗开始12周后测量脂质和葡萄糖代谢标志物的水平及变化百分比。
血糖和糖化血红蛋白（HbA1c）均显著降低。在血脂参数中，总胆固醇（TC）和非高密度脂蛋白胆固醇（non-HDL-C）显著降低（TC降低3.6±15.6%，non-HDL-C降低2.9±19.7%；P<0.05）。分层分析显示，高甘油三酯（TG）组（≥150 mg/dL）的TC、低密度脂蛋白胆固醇（LDL-C）和non-HDL-C显著降低（P<0.05）。按人口统计学因素分层分析显示，TC、LDL-C和non-HDL-C的变化存在显著差异。多变量分析显示，高TG组（≥150 mg/dL）的TC、LDL-C和non-HDL-C水平显著降低，使用强效他汀类药物的患者的TC和LDL-C也显著降低。
结果表明，西格列汀可使TC、LDL-C和non-HDL-C显著降低，尤其是基线TG水平较高的患者以及使用强效他汀类药物的患者。
