Teragawa Hiroki, Morimoto Takeshi, Fujii Yuichi, Ueda Tomohiro, Sakuma Mio, Shimabukuro Michio, Arasaki Osamu, Node Koichi, Nomiyama Takashi, Ueda Shinichiro
Department of Cardiovascular Medicine, JR Hiroshima Hospital, Hiroshima, Japan.
Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan.
Diabetes Metab Syndr Obes. 2022 Mar 3;15:685-694. doi: 10.2147/DMSO.S350518. eCollection 2022.
The effects of two types of dipeptidyl peptidase-4 (DPP-4) inhibitors on renal function remain unclear. Thus, we investigated the effect of anagliptin (ANA) and sitagliptin (SITA) on renal function in patients with type 2 diabetes who participated in the randomized evaluation of ANA versus SITA on low-density lipoprotein-cholesterol (LDL-C) in diabetes (REASON) trial.
We measured the estimated glomerular filtration rate (eGFR) and urinary albumin-creatinine ratio (UACR) before and after the REASON trial. ANA 200 mg/day was administered to 177 patients for 52 weeks, while SITA 50 mg/day was given to 176 patients. We investigated the relationship between differences in renal function and differences in hemoglobin A1c (HbA1c) levels, LDL-C levels, and blood pressure (BP).
No significant differences were found in baseline eGFR and UACR between the two groups. The eGFR levels were significantly decreased in both groups; however, the UACR level was unchanged in the ANA group but elevated in the SITA group, although the difference did not reach significance between the two groups. The difference in eGFR was affected by the differences in HbA1c level and BP, and the difference in the UACR was affected by the differences in LDL-C level and BP, which were reduced only in the ANA group.
These findings imply that the effects of DPP-4 inhibitors on renal function, especially on UACR, may be different between the types of DPP-4 inhibitors.
两种二肽基肽酶-4（DPP-4）抑制剂对肾功能的影响尚不清楚。因此，我们在参与糖尿病患者中阿格列汀（ANA）与西他列汀（SITA）对低密度脂蛋白胆固醇（LDL-C）的随机评估（REASON）试验的2型糖尿病患者中，研究了阿格列汀（ANA）和西他列汀（SITA）对肾功能的影响。
我们在REASON试验前后测量了估计肾小球滤过率（eGFR）和尿白蛋白肌酐比值（UACR）。177例患者接受每日200mg阿格列汀治疗52周，176例患者接受每日50mg西他列汀治疗。我们研究了肾功能差异与糖化血红蛋白（HbA1c）水平、LDL-C水平和血压（BP）差异之间的关系。
两组患者的基线eGFR和UACR无显著差异。两组患者的eGFR水平均显著下降；然而，ANA组的UACR水平未发生变化，而SITA组的UACR水平升高，尽管两组之间的差异未达到显著水平。eGFR的差异受HbA1c水平和BP差异的影响，UACR的差异受LDL-C水平和BP差异的影响，而这些差异仅在ANA组中有所降低。
这些发现表明，DPP-4抑制剂对肾功能的影响，尤其是对UACR的影响，可能因DPP-4抑制剂类型的不同而有所差异。
