title: Efficacy of dipeptidyl-peptidase-4 inhibitors and impact on β-cell function in Asian and Caucasian type 2 diabetes mellitus patients: A meta-analysis.
abstract: BACKGROUND
  This work aimed to compare the efficacy of dipeptidyl peptidase-IV (DPP-4) inhibitors and their impact on β-cell function in Asian and Caucasian patients with type 2 diabetes mellitus.
  
  
  METHODS
  Databases were systematically searched and qualifying studies that compared DPP-4 inhibitors with other antidiabetic medications in type 2 diabetes were included.
  
  
  RESULTS
  A total of 68 studies were included in the meta-analysis. Comparison of DPP-4 inhibitors with placebo in Asian patients showed a decrease in glycosylated hemoglobin (HbA1c ) favoring DPP-4 inhibitors (weighted mean difference [WMD], -0.81%; 95% confidence interval [CI], -0.95% to -0.68%; P < 0.001). Comparison of HbA1c changes between Asian and Caucasian patients showed a significant between-group difference of -0.18% (95% CI, -0.32% to -0.04%; P = 0.011) when compared with placebo. In Asian patients, the homeostatic model assessment for β-cell function (HOMA-β) was increased with DPP-4 inhibitors compared with placebo (WMD, 7.90; 95% CI, 4.29 to 11.51; P < 0.001), although to a lesser extent in Caucasian patients. Comparisons between Asian and Caucasian patients showed a significant between-group difference of -4.97 (95% CI, -9.86 to -0.09; P = 0.046) compared with placebo. Body weight increase with DPP-4 inhibitors compared with placebo was comparable in Asian and Caucasian studies (WMD, 0.37 kg and 0.45 kg and 95% CI, 0.04-0.69 and 0.27-0.62, respectively).
  
  
  CONCLUSIONS
  The glucose-lowering efficacy of DPP-4 inhibitors was greater in Asian patients than in Caucasian patients, although the effect on β-cell function was inferior in Asian patients. The effect of DPP-4 inhibitors on insulin resistance and body weight in Asian patients was comparable with that observed in Caucasian patients.
authors.affiliation: Endocrinology and Metabolism Department, Peking University People's Hospital, Beijing, China.
authors.forename: Xiaoling
authors.initials: X
authors.lastname: Cai
authors.forename: Xueyao
authors.initials: X
authors.lastname: Han
authors.forename: Yingying
authors.initials: Y
authors.lastname: Luo
authors.forename: Linong
authors.initials: L
authors.lastname: Ji
mesh_terms: D044466:Asian People / Q000706:statistics & numerical data*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000208:ethnology*; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000627:therapeutic use*; D006801:Humans; D050417:Insulin-Secreting Cells / Q000187:drug effects*; D016896:Treatment Outcome; D044465:White People / Q000706:statistics & numerical data*
chemical_list: D054873:Dipeptidyl-Peptidase IV Inhibitors
keywords: Asian; Caucasian; dipeptidyl peptidase-4 inhibitor; pancreatic β-cell function; type 2 diabetes mellitus; 关键词：亚洲人，白种人，DPP-4抑制剂，胰腺β细胞功能，2型糖尿病。