Feng Yiduo, Shang Beibei, Yang Yu, Zhang Donglei, Liu Changbin, Qin Zheng, Zhou Yilun, Meng Jie, Liu Xin
Department of Nephrology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China.
Department of Pharmacy, Children's Hospital, Capital Institute of Paediatrics, Beijing 100020, China.
J Clin Endocrinol Metab. 2025 Mar 17;110(4):1195-1204. doi: 10.1210/clinem/dgae783.
Accumulating evidence had implicated pathological involvement of interleukins (ILs) in progression and complications in patients with type 2 diabetes mellitus (T2DM). Dipeptidyl peptidase-4 inhibitors (DPP-4i) produced favorable effects on glucose homeostasis in T2DM. This study aimed to evaluate the impact of DPP-4i on IL concentrations in T2DM.
PubMed, Embase, and the Cochrane library were systematically searched for relevant articles from inception to May 31, 2024. The search included DPP-4i, T2DM, and randomized controlled trials (RCTs) and related terms.
Placebo- or active agents-controlled human studies were screened. All the RCTs were identified if they provided detailed information on changes of ILs during DPP-4i treatment.
A total of 14 RCTs involving 850 participants were identified. Pooled estimates revealed that DPP-4i significantly lowered IL-6 concentrations (-0.54 pg/mL; 95% CI, -0.82 to -0.25; I2 = 10%, P = .0003) compared to placebo. Similar effects were demonstrated for IL-1β (-16.33 pg/mL; 95% CI, -19.56 to -13.11; I2 = 0%, P < .00001), whereas the effect on IL-18 was not statistically significant (-13.55 pg/mL; 95% CI, -76.95 to 49.85; I2 = 0%, P = .68). Subgroup analysis on IL-6 demonstrated that marked effects were found in groups of basal IL-6 concentrations (< 5 pg/mL), body mass index (≥ 28 kg/m2) and type of DPP-4i (linagliptin).
DPP-4i favorably decreased IL-6 levels in patients with T2DM. The impact of DPP-4i on IL-1β and IL-18 needed to be explored with more studies. Further trials should be performed to elucidate this anti-inflammatory effect of DPP-4i during treatment of T2DM.
越来越多的证据表明，白细胞介素（ILs）的病理参与与2型糖尿病（T2DM）患者的病情进展及并发症有关。二肽基肽酶-4抑制剂（DPP-4i）对T2DM患者的血糖稳态产生了有益影响。本研究旨在评估DPP-4i对T2DM患者IL浓度的影响。
对PubMed、Embase和Cochrane图书馆进行系统检索，以查找从创刊至2024年5月31日的相关文章。检索词包括DPP-4i、T2DM、随机对照试验（RCTs）及相关术语。
筛选安慰剂或活性药物对照的人体研究。如果所有RCTs提供了DPP-4i治疗期间ILs变化的详细信息，则将其纳入。
共纳入14项RCTs，涉及850名参与者。汇总估计显示，与安慰剂相比，DPP-4i显著降低了IL-6浓度（-0.54 pg/mL；95%CI，-0.82至-0.25；I2 = 10%，P = .0003）。对IL-1β也有类似效果（-16.33 pg/mL；95%CI，-19.56至-13.11；I2 = 0%，P < .00001），而对IL-18的影响无统计学意义（-13.55 pg/mL；95%CI，-76.95至49.85；I2 = 0%，P = .68）。对IL-6的亚组分析表明，在基础IL-6浓度（<5 pg/mL）、体重指数（≥28 kg/m2）和DPP-4i类型（利格列汀）的组中发现了显著影响。
DPP-4i可有效降低T2DM患者的IL-6水平。DPP-4i对IL-1β和IL-18的影响需要更多研究来探索。应进行进一步试验以阐明DPP-4i在T2DM治疗期间的这种抗炎作用。
