A comparison of effects of DPP-4 inhibitor and SGLT2 inhibitor on lipid profile in patients with type 2 diabetes.
BACKGROUND
Previous studies suggest that dipeptidyl peptidase-4 (DPP-4) inhibitors and sodium glucose cotransporter 2 (SGLT2) inhibitors have different effects on the lipid profile in patients with type 2 diabetes. We investigated the effects of DPP-4 inhibitors and SGLT2 inhibitors on the lipid profile in patients with type 2 diabetes.


METHODS
From January 2013 to December 2015, a total of 228 patients with type 2 diabetes who were receiving a DPP-4 inhibitor or SGLT2 inhibitor as add-on therapy to metformin and/or a sulfonylurea were consecutively enrolled. We compared the effects of DPP-4 inhibitors and SGLT2 inhibitors on the lipid profile at baseline and after 24 weeks of treatment. To compare lipid parameters between the two groups, we used the analysis of covariance (ANCOVA).


RESULTS
A total of 184 patients completed follow-up (mean age: 53.1 ± 6.9 years, mean duration of diabetes: 7.1 ± 5.7 years). From baseline to 24 weeks, HDL-cholesterol (HDL-C) levels were increased by 0.5 (95% CI, -0.9 to 2.0) mg/dl with a DPP-4 inhibitor and by 5.1 (95% CI, 3.0 to 7.1) mg/dl with an SGLT2 inhibitor (p = 0.001). LDL-cholesterol (LDL-C) levels were reduced by 8.4 (95% CI, -14.0 to -2.8) mg/dl with a DPP-4 inhibitor, but increased by 1.3 (95% CI, -5.1 to 7.6) mg/dl with an SGLT2 inhibitor (p = 0.046). There was no significant difference in the mean hemoglobin A1c (8.3 ± 1.1 vs. 8.0 ± 0.9%, p = 0.110) and in the change of total cholesterol (TC) (p = 0.836), triglyceride (TG) (p = 0.867), apolipoprotein A (p = 0.726), apolipoprotein B (p = 0.660), and lipoprotein (a) (p = 0.991) between the DPP-4 inhibitor and the SGLT2 inhibitor.


CONCLUSIONS
The SGLT2 inhibitor was associated with a significant increase in HDL-C and LDL-C after 24 weeks of SGLT2 inhibitor treatment in patients with type 2 diabetes compared with those with DPP-4 inhibitor treatment in this study.


TRIAL REGISTRATION
This study was conducted by retrospective medical record review.
['Cha|Seon-Ah|SA|', 'Park|Yong-Moon|YM|', 'Yun|Jae-Seung|JS|', 'Lim|Tae-Seok|TS|', 'Song|Ki-Ho|KH|', 'Yoo|Ki-Dong|KD|', 'Ahn|Yu-Bae|YB|', 'Ko|Seung-Hyun|SH|']
D001559:Benzhydryl Compounds D002318:Cardiovascular Diseases D003924:Diabetes Mellitus, Type 2 D003925:Diabetic Angiopathies D058065:Diabetic Cardiomyopathies D054873:Dipeptidyl-Peptidase IV Inhibitors D004359:Drug Therapy, Combination D005260:Female D005500:Follow-Up Studies D005960:Glucosides D006442:Glycated Hemoglobin A D006801:Humans D006943:Hyperglycemia D006949:Hyperlipidemias D000069476:Linagliptin D008297:Male D049990:Membrane Transport Modulators D008875:Middle Aged D010881:Piperidones D011743:Pyrimidines D056910:Republic of Korea D012189:Retrospective Studies D012307:Risk Factors D051297:Sodium-Glucose Transporter 2 D000077203:Sodium-Glucose Transporter 2 Inhibitors
DPP-4 inhibitor SGLT2 inhibitor Lipid Type 2 diabetes