Expert Opin Investig Drugs. 2019 Apr;28(4):377-388. doi: 10.1080/13543784.2019.1592156. Epub 2019 Mar 19.
DPP-4 inhibitors have pleomorphic effects that extend beyond the anti-hyperglycemic labeled use of the drug. DPP-4 inhibitors have demonstrated promising renal protective effects in T2DM and T1DM and protective effects against immune destruction of pancreatic beta-cells in T1DM.
The efficacy of DPP-4 inhibitors in the treatment of diabetic kidney disease and possible adjunct with insulin in the treatment of T1DM to preserve beta-cell function. Pertinent literature was identified through Medline, PubMed and ClinicalTrials.gov (1997-November 2018) using the search terms T1DM, sitagliptin, vildagliptin, linagliptin, beta-cell function, diabetic nephropathy. Only articles are written in the English language, and clinical trials evaluating human subjects were used.
DPP-4 inhibitors can be used safely in patients with diabetic kidney disease and do not appear to exacerbate existing diabetic nephropathy. Linagliptin reduces albuminuria and protects renal endothelium from the deleterious effects of hyperglycemia. The effects of DPP-4 inhibitors on preserving beta-cell function in certain subtypes of T1DM [e.g. Latent Autoimmune Diabetes in Adult (LADA) and Slowly Progressive Type 1 Diabetes (SPIDDM)] are encouraging and show promise.
DPP-4 抑制剂具有多种作用，超出了药物的抗高血糖标签用途。DPP-4 抑制剂在 2 型糖尿病和 1 型糖尿病中显示出有希望的肾脏保护作用，并且在 1 型糖尿病中对胰岛β细胞的免疫破坏具有保护作用。
DPP-4 抑制剂在治疗糖尿病肾病中的疗效，以及在治疗 1 型糖尿病时可能与胰岛素联合使用以保护β细胞功能。通过 Medline、PubMed 和 ClinicalTrials.gov（1997 年-2018 年 11 月）使用 T1DM、西格列汀、维格列汀、利格列汀、β细胞功能、糖尿病肾病等搜索词来确定相关文献。仅使用评估人类受试者的英语书写的临床试验。
DPP-4 抑制剂可安全用于糖尿病肾病患者，并且似乎不会加重现有的糖尿病肾病。利格列汀可减少蛋白尿，并保护肾脏内皮免受高血糖的有害影响。DPP-4 抑制剂在某些 1 型糖尿病亚型（如成人隐匿性自身免疫性糖尿病（LADA）和缓慢进展型 1 型糖尿病（SPIDDM））中对保护β细胞功能的作用令人鼓舞，并且有希望。
