Terawaki Yuichi, Nomiyama Takashi, Takahashi Hiroyuki, Tsutsumi Yoko, Murase Kunitaka, Nagaishi Ryoko, Tanabe Makito, Kudo Tadachika, Kobayashi Kunihisa, Yasuno Tetsuhiko, Nakashima Hitoshi, Yanase Toshihiko
Department of Endocrinology and Diabetes Mellitus, School of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180 Japan.
Department of Endocrinology and Diabetes Mellitus, Fukuoka University Chikushi Hospital, 1-1-1 Zokumyouin, Chikushino, Fukuoka 818-0067 Japan.
Diabetol Metab Syndr. 2015 May 17;7:44. doi: 10.1186/s13098-015-0043-2. eCollection 2015.
Incretin therapy is feasible in patients with type 2 diabetes mellitus undergoing hemodialysis (HD). However, few studies have examined the safety and efficacy of this therapeutic approach in patients with diabetes and renal impairment. Here, we examined glycemic control and the anti-oxidative-stress effects of the dipeptidyl peptidase (DPP)-4 inhibitor linagliptin in patients with type 2 diabetes undergoing HD.
Thirty-five patients with type 2 diabetes undergoing HD (including 13 insulin-treated patients) were switched from ongoing therapy to linagliptin (5 mg, once daily). Levels of fasting blood glucose, C-peptide immunoreactivity (CPR), glycated albumin, B-type natriuretic peptide, oxidized low-density lipoprotein (oxLDL), high-sensitivity C-reactive protein, 8-hydroxy-2'-deoxyguanosine (8OHdG), body mass index, blood pressure, and other biologic characteristics (liver function, renal function, lipid profile) were determined before and 3 months after linagliptin treatment. Patients were classified into insulin-treated and non-insulin groups.
With the exception of levels of total bilirubin, aspartate aminotransferase, and CPR, none of the patients exhibited changes in glucose metabolism after switching to linagliptin treatment. However, oxLDL levels were decreased significantly by linagliptin therapy in the non-insulin-treated group despite the absence of changes in glycemic control.
Linagliptin can decrease serum levels of oxLDL in patients with type 2 diabetes undergoing HD independent of its glucose-lowering effect.
肠促胰岛素疗法对于接受血液透析（HD）的2型糖尿病患者是可行的。然而，很少有研究探讨这种治疗方法在糖尿病合并肾功能损害患者中的安全性和有效性。在此，我们研究了二肽基肽酶（DPP）-4抑制剂利格列汀对接受HD的2型糖尿病患者血糖控制及抗氧化应激的作用。
35例接受HD的2型糖尿病患者（包括13例接受胰岛素治疗的患者）从当前治疗方案转换为利格列汀治疗（5毫克，每日一次）。在利格列汀治疗前及治疗3个月后测定空腹血糖、C肽免疫反应性（CPR）、糖化白蛋白、B型利钠肽、氧化型低密度脂蛋白（oxLDL）、高敏C反应蛋白、8-羟基-2'-脱氧鸟苷（8OHdG）、体重指数、血压及其他生物学特征（肝功能、肾功能、血脂谱）。患者被分为胰岛素治疗组和非胰岛素治疗组。
除总胆红素、天冬氨酸转氨酶和CPR水平外，转换为利格列汀治疗后，所有患者的糖代谢均未出现变化。然而，在非胰岛素治疗组中，尽管血糖控制无变化，但利格列汀治疗可显著降低oxLDL水平。
利格列汀可降低接受HD的2型糖尿病患者的血清oxLDL水平，且与其降糖作用无关。
