Takamiya Yosuke, Kobayashi Kunihisa, Kudo Tadachika, Okuda Tetsu, Okamura Keisuke, Shirai Kazuyuki, Urata Hidenori
Department of Cardiovascular Diseases, Fukuoka University Chikushi Hospital, Chikushino, Japan.
Department of Endocrinology and Diabetes Mellitus, Fukuoka University Chikushi Hospital, Chikushino, Japan.
J Clin Med Res. 2020 Jul;12(7):423-430. doi: 10.14740/jocmr4224. Epub 2020 Jun 25.
This study aimed to verify the safety and efficacy, including glycemic control, of the selective dipeptidyl peptidase 4 inhibitor alogliptin in patients with type 2 diabetes.
This study used a multi-center, open-label, prospective observational design. Type 2 diabetes patients who were undergoing dietary therapy and/or exercise therapy alone without sufficient glycemic control (hemoglobin A1c (HbA1c) ≥ 6.5% and < 10%) were administered alogliptin (25 mg/day). The long-term effects (6 and 12 months) on blood glucose, blood pressure, heart rate, body weight and lipids were assessed.
A final 50 patients were included with a high prevalence of hypertension (77%) and dyslipidemia (72%), and a mean duration of diabetes of 4.5 years. Pre-treatment HbA1c was 7.5% and was significantly decreased at 6 and 12 months (6M: 6.4%, 12M: 6.2%; P < 0.02 vs. 0M, respectively). Body weight, blood pressure and low-density lipoprotein cholesterol were significantly decreased by 6 months and maintained at 12 months. Triglycerides showed a significant decrease at 12 months. No significant differences were observed in HbA1c decrease for different grade of age, duration of diabetes, body mass index and renal function. The degree of decrease in HbA1c was most strongly correlated with pre-treatment HbA1c. Adverse events were noted in three patients, with no serious outcomes.
The blood glucose-lowering effect and safety of alogliptin were demonstrated regardless of baseline HbA1c, although its effect appeared stronger with higher pre-treatment HbA1c values. Additionally, alogliptin appears useful for managing atherosclerotic risk factors such as body weight and blood pressure.
本研究旨在验证选择性二肽基肽酶4抑制剂阿格列汀在2型糖尿病患者中的安全性和有效性,包括血糖控制情况。
本研究采用多中心、开放标签、前瞻性观察设计。对仅接受饮食治疗和/或运动治疗但血糖控制不佳(糖化血红蛋白(HbA1c)≥6.5%且<10%)的2型糖尿病患者给予阿格列汀(25毫克/天)治疗。评估其对血糖、血压、心率、体重和血脂的长期影响(6个月和12个月)。
最终纳入50例患者,高血压患病率高(77%),血脂异常患病率高(72%),糖尿病平均病程4.5年。治疗前HbA1c为7.5%,在6个月和12个月时显著降低(6个月时为6.4%,12个月时为6.2%;与0个月时相比,P均<0.02)。体重、血压和低密度脂蛋白胆固醇在6个月时显著降低,并在12个月时维持该水平。甘油三酯在12个月时显著降低。不同年龄、糖尿病病程、体重指数和肾功能分级的患者在HbA1c降低方面未观察到显著差异。HbA1c降低程度与治疗前HbA1c相关性最强。3例患者出现不良事件,无严重后果。
无论基线HbA1c水平如何,阿格列汀均显示出降糖效果和安全性,尽管治疗前HbA1c值越高其效果似乎越强。此外,阿格列汀似乎有助于管理体重和血压等动脉粥样硬化危险因素。