title: Serum level of soluble CD26/dipeptidyl peptidase-4 (DPP-4) predicts the response to sitagliptin, a DPP-4 inhibitor, in patients with type 2 diabetes controlled inadequately by metformin and/or sulfonylurea.
abstract: Dipeptidyl peptidase 4 (DPP-4) inhibitors is a new class of antihyperglycemic agents that is now available for the treatment of type 2 diabetes. We investigated the relationship between the baseline serum level of soluble CD 26/DPP-4 and the response to treatment with sitagliptin, a DPP-4 inhibitor, over 24 weeks in patients who had type 2 diabetes inadequately controlled by metformin and/or sulfonylurea therapy. We studied 52 consecutive patients with type 2 diabetes who had poor glycemic control despite treatment with metformin and/or sulfonylurea. All patients were given 50 mg/day of sitagliptin and were followed at monthly intervals for 24 weeks. Treatment with sitagliptin decreased significantly hemoglobin A1c (HbA1c) from 7.91 ± 1.08% at baseline to 6.96 ± 1.18% at 8 weeks, 7.04 ± 0.77% at 16 weeks, and 7.08 ± 0.80% at 24 weeks. The baseline serum level of sCD26 was correlated positively with HbA1c at both 16 weeks and 24 weeks. Furthermore, the serum sCD26 level at baseline was also correlated positively with the changes from baseline of HbA1c at 16 and 24 weeks (r = 0.318, P = 0.0296 and r = 0.516, P = 0.0003, respectively). In a multivariate logistic regression model that explained 56.1% (R(2) = 0.561) of the variation of the changes from baseline of HbA1c at 24 weeks, the baseline HbA1c (β = -0.638, P < 0.001) and serum sCD26 (β = 0.357, P = 0.041) were independent determinants of the change of HbA1c at 24 weeks. In conclusions, a higher serum level of sCD26 is associated with a worse response to sitagliptin in patients with type 2 diabetes controlled inadequately by metformin and/or sulfonylurea therapy.
authors.affiliation: Department of Internal Medicine, Koshigaya Hospital, Dokkyo Medical University, Saitama, Japan. yaso@dokkyomed.ac.jp
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Aso
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Ozeki
authors.forename: Tomoko
authors.initials: T
authors.lastname: Terasawa
authors.forename: Rika
authors.initials: R
authors.lastname: Naruse
authors.forename: Kenji
authors.initials: K
authors.lastname: Hara
authors.forename: Mariko
authors.initials: M
authors.lastname: Suetsugu
authors.forename: Kohzo
authors.initials: K
authors.lastname: Takebayashi
authors.forename: Mitsuei
authors.initials: M
authors.lastname: Shibazaki
authors.forename: Kohsuke
authors.initials: K
authors.lastname: Haruki
authors.forename: Kimio
authors.initials: K
authors.lastname: Morita
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Inukai
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000201:enzymology; D018819:Dipeptidyl Peptidase 4 / Q000097:blood; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis / Q000378:metabolism; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000494:pharmacology*; D008297:Male; D008687:Metformin / Q000494:pharmacology / Q000627:therapeutic use; D008875:Middle Aged; D011719:Pyrazines / Q000494:pharmacology* / Q000627:therapeutic use; D000068900:Sitagliptin Phosphate; D013453:Sulfonylurea Compounds / Q000494:pharmacology / Q000627:therapeutic use; D013997:Time Factors; D014230:Triazoles / Q000494:pharmacology* / Q000627:therapeutic use
chemical_list: D001786:Blood Glucose; D018819:Dipeptidyl Peptidase 4; D054873:Dipeptidyl-Peptidase IV Inhibitors; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D008687:Metformin; D011719:Pyrazines; D000068900:Sitagliptin Phosphate; D013453:Sulfonylurea Compounds; D014230:Triazoles