title: Anti-inflammatory effects of linagliptin in hemodialysis patients with diabetes.
abstract: Inflammation and glycemic control are important prognosis-related factors for hemodialysis (HD) patients; moreover, inflammation affects insulin secretion. Here, we evaluated the anti-inflammatory effects of monotherapy with linagliptin-a dipeptidase-4 inhibitor-in HD patients with type 2 diabetes. We examined 21 diabetic HD patients who were not receiving oral diabetes drugs or insulin therapy and with poor glycemic control (glycated albumin [GA] level, >20%). Linagliptin (5 mg) was administered to the patients daily. The levels of prostaglandin E2 (PGE2), interleukin-6 (IL-6), high-sensitivity C-reactive protein, GA, blood glucose, and active glucagon-like peptide-1 were determined before and 6 months after treatment. Body weight and serum levels of albumin, hemoglobin, total cholesterol, and low-density lipoprotein cholesterol were also recorded before and after treatment. The levels of PGE2 and GA were significantly decreased 1 month after starting linagliptin therapy, whereas the IL-6 levels were significantly decreased 6 months after starting linagliptin therapy. After 6 months of treatment, the PGE2 levels decreased from 188 ± 50 ng/mL to 26 ± 5 ng/mL; IL-6 levels, from 1.5 ± 0.4 pg/mL to 0.6 ± 0.1 pg/mL; and GA levels, from 21.3% ± 0.6% to 18.0% ± 0.6%. Glucagon-like peptide-1 levels increased 2.5-fold during the treatment. Over the 6-month treatment period, body weight and levels of high-sensitivity C-reactive protein, blood glucose, albumin, hemoglobin, and cholesterol did not change; none of the patients exhibited hypoglycemia. The anti-inflammatory effects of linagliptin monotherapy indicate that it may serve as a useful glucose control strategy for HD patients with diabetes.
authors.affiliation: Saiyu Soka Hospital, Soka, Japan; Department of Pharmacology, School of Medicine, Showa University, Tokyo, Japan.
authors.forename: Yuya
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Mayumi
authors.initials: M
authors.lastname: Tsuji
authors.forename: Hitomi
authors.initials: H
authors.lastname: Hasegawa
authors.forename: Kengo
authors.initials: K
authors.lastname: Kimura
authors.forename: Kiichiro
authors.initials: K
authors.lastname: Fujita
authors.forename: Michiyasu
authors.initials: M
authors.lastname: Inoue
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Shimizu
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Gotoh
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Goto
authors.forename: Masahiro
authors.initials: M
authors.lastname: Inagaki
authors.forename: Katsuji
authors.initials: K
authors.lastname: Oguchi
mesh_terms: D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000097:blood / Q000628:therapy*; D000069476:Linagliptin; D008297:Male; D011687:Purines / Q000627:therapeutic use*; D011799:Quinazolines / Q000627:therapeutic use*; D006435:Renal Dialysis / Q000379:methods*
chemical_list: D000893:Anti-Inflammatory Agents; D054873:Dipeptidyl-Peptidase IV Inhibitors; D007004:Hypoglycemic Agents; D011687:Purines; D011799:Quinazolines; D000069476:Linagliptin
keywords: GLP-1; IL-6; Linagliptin; PGE2; diabetes; hemodialysis