Mikov Momir, Pavlović Nebojša, Stanimirov Bojan, Đanić Maja, Goločorbin-Kon Svetlana, Stankov Karmen, Al-Salami Hani
Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Novi Sad, Novi Sad, Vojvodina, Serbia.
Department of Pharmacy, Faculty of Medicine, University of Novi Sad, Novi Sad, Vojvodina, Serbia.
Eur J Drug Metab Pharmacokinet. 2020 Feb;45(1):1-14. doi: 10.1007/s13318-019-00570-y.
The continuously increasing incidence of diabetes worldwide has attracted the attention of the scientific community and driven the development of a novel class of antidiabetic drugs that can be safely and effectively used in diabetic patients. Of particular interest in this context are complications associated with diabetes, such as renal impairment, which is the main cause of high cardiovascular morbidity and mortality in diabetic patients. Intensive control of glucose levels and other risk factors associated with diabetes and metabolic syndrome provides the foundations for both preventing and treating diabetic nephropathy. Dipeptidyl peptidase-4 (DPP-4) inhibitors represent a highly promising novel class of oral agents used in the treatment of type 2 diabetes mellitus that may be successfully combined with currently available antidiabetic therapeutics in order to achieve blood glucose goals. Beyond glycemic control, emerging evidence suggests that DPP-4 inhibitors may have desirable off-target effects, including renoprotection. All type 2 diabetes mellitus patients with impaired renal function require dose adjustment of any DPP-4 inhibitor administered except for linagliptin, for which renal excretion is a minor elimination pathway. Thus, linagliptin is the drug most frequently chosen to treat type 2 diabetes mellitus patients with renal failure.
全球糖尿病发病率持续上升，已引起科学界关注，并推动了一类新型抗糖尿病药物的研发，这类药物可安全有效地用于糖尿病患者。在这种情况下，特别值得关注的是与糖尿病相关的并发症，如肾功能损害，它是糖尿病患者心血管发病率和死亡率高的主要原因。严格控制血糖水平以及与糖尿病和代谢综合征相关的其他风险因素，为预防和治疗糖尿病肾病奠定了基础。二肽基肽酶-4（DPP-4）抑制剂是一类极具前景的新型口服药物，用于治疗2型糖尿病，可与目前可用的抗糖尿病疗法成功联合使用，以实现血糖目标。除血糖控制外，新出现的证据表明，DPP-4抑制剂可能具有理想的非靶向效应，包括肾脏保护作用。所有肾功能受损的2型糖尿病患者，除利格列汀外，使用任何DPP-4抑制剂时均需调整剂量，利格列汀经肾脏排泄是次要消除途径。因此，利格列汀是治疗肾衰竭2型糖尿病患者最常选用的药物。
