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Influence of IDPP-4 on Fat Metabolism in Patients with Type 2 Diabetes

Received: 21 October 2018    Accepted: 10 November 2018    Published: 3 January 2019
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Abstract

According to IDF, more than 425 million people in the age of 20 to 79 all around the world are suffering from type 2 diabetes. In 2045, the number of people will reach 629 million. Such a rapid increase in the prevalence of type 2 diabetes is associated with increasing of patients with obesity. A whole range of mechanisms involving many organs and hormonal systems supports glucose homeostasis, and dysfunction of this systems leads to the development and progression of insulin resistance and the development of complications. Early start of therapy that aimed at the maximum number of pathophysiological targets can slow the progression of disease and prevent. The purpose of our study is to evaluate the influence of combined therapy of sitagliptin and metformin on fat metabolism in patients with type 2 diabetes mellitus. The study included 82 patients (age, 55.3±9.1 years) with obesity and lipid metabolism disorders. None of the patients had reached their target glycated hemoglobin levels after metformin and diet therapy. Patients in group 1 (n=42) received 1.5–2-g metformin daily before the study and were switched to a formulation of 100-mg sitagliptin and 2-g metformin once a day. Patients in group 2 (n=40) were on a diet therapy before inclusion and were started on 2-g metformin/day. The following were evaluated at baseline and after 6 months of therapy: fasting glucose levels, postprandial glucose levels, glycated hemoglobin, weight, body mass index, waist circumference and lipid profile; insulin, proinsulin, leptin and adiponectin levels; insulin resistance using the homeostatic model assessment (HOMA) of β-cell function (HOMA-β) and insulin resistance (HOMA-IR). In addition, magnetic resonance imaging was performed to assess the amount of visceral fat for the total cohort. As the result of intensification of therapy by adding sitagliptin to metformin, in patients with type 2 diabetes, compared to monotherapy with metformin, we got more pronounced important non – glycemic effects in the form of a decrease in the visceral fat depot, an improvement in functional activity of pancreatic β-cells, which is the leading pathogenesis mechanism for improving glycemic control.

Published in International Journal of Clinical and Experimental Medical Sciences (Volume 4, Issue 6)
DOI 10.11648/j.ijcems.20180406.11
Page(s) 78-86
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Sitagliptin, Visceral Fat, Fat Metabolism, Type 2 Diabetes, Adiponectin, Leptin

References
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[3] Jose T. Inzucchi S. Cardiovascular effects of the DPP-4 inhibitors. Diabetes and Vascular Disease Research-2012-№2:109-116.
[4] Satoh-Asahara N. Sasaki Y., Wada H. et al. A dipeptidyl peptidase-4 inhibitor, sitagliptin, exerts anti-inflammatory effects in type 2 diabetic patients. Metabolism-2013-№3:347-351.
[5] Derosa G. Ragonesi P., Fogaria E. at al. Sitagliptin added to previously taken anti-diabetic agents on insulin resistance and lipid profile: a two years study evaluation. Fundam Clin Pharmacol-2012-№2:221-229.
[6] Aschner P. Kipnes M., Lunceford J., et al. Effect of the dipeptidyl peptidase-4 inhibitor sitagliptin as monotherapy on glycemic control in patients with type 2 diabetes. Diabetes Care- 2006-№ 12:2632–2637.
[7] Aschner P. Katzeff H., Guo H. et al. Efficacy and safety of monotherapy of sitagliptin compared with metformin in patients with type2 diabetes. Diabetes Obesity and Metabolism-2010-№3:252–261.
[8] Aschner P. et al. Insulin glargine versus sitagliptin in insulin-naïve patients with type 2 diabetes mellitus uncontrolled on metformin (EASIE); a multicenter randomized open-label trial. The Lancet- 2012-№9833:2262-2269.
[9] Derosa G., Carbone A., Franzetti I. Effects of a combination of sitagliptin plus metformin vs metformin monotherapy on glycemic control, β-cell function and insulin resistance in type 2 diabetic patients. Diabetes Research and Clinical Practice- 2012-№1:51-60.
[10] Hong E., Khang A., Yoon J. et al. Comparison between sitagliptin as add-on therapy to insulin and insulin dose-increase therapy in uncontrolled Korean type 2 diabetes: CSI study. Diabetes, Obesity, Metabolism.- 2012-№9:795–802.
[11] Vilsbøll T., Rosenstock J., Yki- -Järvinen H. et al. Efficacy and safety of sitagliptin when added to insulin therapy in patients with type 2 diabetes. Diabetes Obesity Metabolism-2010.-№2:167–177.
[12] Xu L. Man C., Charbonnel B. et al Effect of sitagliptin, a dipeptidyl peptidase-4 inhibitor, on beta-cell function in patients with type 2 diabetes: a model-based approach. Diabetes Obesity Metabolism.-2008-№12:1212–1220.
[13] Migoya E. Bergeron R., Miller J. et al. Dipeptidyl peptidase-4 inhibitors administered in combination with metformin result in an additive increase in the plasma concentration of active GLP-1. Clin Pharmacol Ther.- 2010-№6:801–808.
[14] Ametov A. S., Pakus E. N. Efficacy and safety of metformin-sitagliptin combination for the treatment of patients with diabetes mellitus and obesity. Diabetes mellitus- 2010.№3:62-64.
[15] Lamers D. Famulla S., Wronkowitz N. et al. Dipeptidyl Peptidase 4 Is a Novel Adipokine Potentially Linking Obesity to the Metabolic Syndrome. Diabetes-2011-№7:1917—1925.
[16] Sell H., Matthias B. Kloting N. et al. Adipose Dipeptidyl Peptidase-4 and Obesity: Correlation with insulin resistance and depot-specific release from adipose tissue in vivo and in vitro. Diabetes Care -2013-№ 12:4083-4090.
[17] Seck T., Nauck M., Sheng D. Safety and efficacy of treatment with sitagliptin or glipizide in patients with type 2 diabetes inadequately controlled on metformin: A 2-year study. International Journal of Clinical Practice-2010-№5:562-576.
[18] Klebanova EM, Balabolkin MI. Hormones of adipose tissue and their role in the pathogenesis of diabetes mellitus type 2. Lechashchii vrach. 2010; (11):27.
[19] Ametov AS. Diabetes type 2. Problems and solutions. Vol. 2. 3rd ed. Moscow; 2015.
[20] Pocai A., Carrington P., Adams J., et al. Glucagon-Like Peptide 1/Glucagon Receptor Dual Agonism Reverses Obesity in Mice. Diabetes.-№10-2009:2258–2266.
[21] Kim Ch., Hosaka T., Yoshida M. et al. Exendin-4, a GLP-1 receptor agonist, directly induces adiponectin expression through protein kinase A pathway and prevents inflammatory adipokine expression. Biochemical and Biophysical Research Communications.- 2009-№3:613–618.
[22] Nomura Sh., Omoto S., Taniura T. et al. Anti-atherosclerotic effects of sitagliptin in patients with type 2 diabetes mellitus. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy- 2015:339.
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[24] https://www.intechopen.com/books/diabetes-and-its-complications/dpp-4-inhibitors-and-fat-metabolism-in-patients-with-type-2-diabetes.
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  • APA Style

    Ametov Alexander Sergeevich, Gusenbekova Dinara Gadjimagomedovna. (2019). Influence of IDPP-4 on Fat Metabolism in Patients with Type 2 Diabetes. International Journal of Clinical and Experimental Medical Sciences, 4(6), 78-86. https://doi.org/10.11648/j.ijcems.20180406.11

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    ACS Style

    Ametov Alexander Sergeevich; Gusenbekova Dinara Gadjimagomedovna. Influence of IDPP-4 on Fat Metabolism in Patients with Type 2 Diabetes. Int. J. Clin. Exp. Med. Sci. 2019, 4(6), 78-86. doi: 10.11648/j.ijcems.20180406.11

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    AMA Style

    Ametov Alexander Sergeevich, Gusenbekova Dinara Gadjimagomedovna. Influence of IDPP-4 on Fat Metabolism in Patients with Type 2 Diabetes. Int J Clin Exp Med Sci. 2019;4(6):78-86. doi: 10.11648/j.ijcems.20180406.11

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  • @article{10.11648/j.ijcems.20180406.11,
      author = {Ametov Alexander Sergeevich and Gusenbekova Dinara Gadjimagomedovna},
      title = {Influence of IDPP-4 on Fat Metabolism in Patients with Type 2 Diabetes},
      journal = {International Journal of Clinical and Experimental Medical Sciences},
      volume = {4},
      number = {6},
      pages = {78-86},
      doi = {10.11648/j.ijcems.20180406.11},
      url = {https://doi.org/10.11648/j.ijcems.20180406.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcems.20180406.11},
      abstract = {According to IDF, more than 425 million people in the age of 20 to 79 all around the world are suffering from type 2 diabetes. In 2045, the number of people will reach 629 million. Such a rapid increase in the prevalence of type 2 diabetes is associated with increasing of patients with obesity. A whole range of mechanisms involving many organs and hormonal systems supports glucose homeostasis, and dysfunction of this systems leads to the development and progression of insulin resistance and the development of complications. Early start of therapy that aimed at the maximum number of pathophysiological targets can slow the progression of disease and prevent. The purpose of our study is to evaluate the influence of combined therapy of sitagliptin and metformin on fat metabolism in patients with type 2 diabetes mellitus. The study included 82 patients (age, 55.3±9.1 years) with obesity and lipid metabolism disorders. None of the patients had reached their target glycated hemoglobin levels after metformin and diet therapy. Patients in group 1 (n=42) received 1.5–2-g metformin daily before the study and were switched to a formulation of 100-mg sitagliptin and 2-g metformin once a day. Patients in group 2 (n=40) were on a diet therapy before inclusion and were started on 2-g metformin/day. The following were evaluated at baseline and after 6 months of therapy: fasting glucose levels, postprandial glucose levels, glycated hemoglobin, weight, body mass index, waist circumference and lipid profile; insulin, proinsulin, leptin and adiponectin levels; insulin resistance using the homeostatic model assessment (HOMA) of β-cell function (HOMA-β) and insulin resistance (HOMA-IR). In addition, magnetic resonance imaging was performed to assess the amount of visceral fat for the total cohort. As the result of intensification of therapy by adding sitagliptin to metformin, in patients with type 2 diabetes, compared to monotherapy with metformin, we got more pronounced important non – glycemic effects in the form of a decrease in the visceral fat depot, an improvement in functional activity of pancreatic β-cells, which is the leading pathogenesis mechanism for improving glycemic control.},
     year = {2019}
    }
    

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  • TY  - JOUR
    T1  - Influence of IDPP-4 on Fat Metabolism in Patients with Type 2 Diabetes
    AU  - Ametov Alexander Sergeevich
    AU  - Gusenbekova Dinara Gadjimagomedovna
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    DO  - 10.11648/j.ijcems.20180406.11
    T2  - International Journal of Clinical and Experimental Medical Sciences
    JF  - International Journal of Clinical and Experimental Medical Sciences
    JO  - International Journal of Clinical and Experimental Medical Sciences
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    EP  - 86
    PB  - Science Publishing Group
    SN  - 2469-8032
    UR  - https://doi.org/10.11648/j.ijcems.20180406.11
    AB  - According to IDF, more than 425 million people in the age of 20 to 79 all around the world are suffering from type 2 diabetes. In 2045, the number of people will reach 629 million. Such a rapid increase in the prevalence of type 2 diabetes is associated with increasing of patients with obesity. A whole range of mechanisms involving many organs and hormonal systems supports glucose homeostasis, and dysfunction of this systems leads to the development and progression of insulin resistance and the development of complications. Early start of therapy that aimed at the maximum number of pathophysiological targets can slow the progression of disease and prevent. The purpose of our study is to evaluate the influence of combined therapy of sitagliptin and metformin on fat metabolism in patients with type 2 diabetes mellitus. The study included 82 patients (age, 55.3±9.1 years) with obesity and lipid metabolism disorders. None of the patients had reached their target glycated hemoglobin levels after metformin and diet therapy. Patients in group 1 (n=42) received 1.5–2-g metformin daily before the study and were switched to a formulation of 100-mg sitagliptin and 2-g metformin once a day. Patients in group 2 (n=40) were on a diet therapy before inclusion and were started on 2-g metformin/day. The following were evaluated at baseline and after 6 months of therapy: fasting glucose levels, postprandial glucose levels, glycated hemoglobin, weight, body mass index, waist circumference and lipid profile; insulin, proinsulin, leptin and adiponectin levels; insulin resistance using the homeostatic model assessment (HOMA) of β-cell function (HOMA-β) and insulin resistance (HOMA-IR). In addition, magnetic resonance imaging was performed to assess the amount of visceral fat for the total cohort. As the result of intensification of therapy by adding sitagliptin to metformin, in patients with type 2 diabetes, compared to monotherapy with metformin, we got more pronounced important non – glycemic effects in the form of a decrease in the visceral fat depot, an improvement in functional activity of pancreatic β-cells, which is the leading pathogenesis mechanism for improving glycemic control.
    VL  - 4
    IS  - 6
    ER  - 

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Author Information
  • Russian Medical Academy of Continuing Professional Education, Moscow, Russian Federation

  • Russian Medical Academy of Continuing Professional Education, Moscow, Russian Federation

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