title: Renal Protective Effect of DPP-4 Inhibitors in Type 2 Diabetes Mellitus Patients: A Cohort Study.
abstract: Aims. Dipeptidyl-peptidase IV inhibitors (DPP-4i) are among the most popular oral antidiabetic agents. However, the effects of DPP-4i on diabetic nephropathy are not well-established. The aim of this study was to determine the renoprotective effects of DPP-4i, using albuminuria and glomerular filtration rate (GFR) as indicators, in type 2 diabetes mellitus (T2DM) patients.Methods. This retrospective observational cohort study used the clinical database of a tertiary hospital. The changes of urine albumin/creatinine ratio (UACR), estimated GFR (eGFR), and metabolic parameters after treatment were compared with the changes of those parameters before treatment using paired Student'st-test.Results. The mean UACR in the entire study population decreased to approximately 45 mg/g 1 year after DPP-4i treatment, while it was increased approximately 39 mg/g 1 year before DPP-4i treatment (p< 0.05). Patients with macroalbuminuria showed a significant reduction in albumin levels after DPP-4i treatment (p< 0.05); however, patients with microalbuminuria and normoalbuminuria did not show improvements in albuminuria levels after treatment. Although eGFR was not changed 1 year after DPP-4i treatment, reductions in eGFR were slowed in patients with microalbuminuria and reversed in the macroalbuminuria or normoalbuminuria groups, 4 years after treatment.Conclusions. Administration of DPP-4i reduces urine albumin excretion and mitigates reduction of eGFR in T2DM patients.
authors.affiliation: Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Young-Gun
authors.identifier: 0000-0002-8982-5230
authors.initials: YG
authors.lastname: Kim
authors.affiliation: Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: JungHyun
authors.initials: J
authors.lastname: Byun
authors.affiliation: Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Dukyong
authors.initials: D
authors.lastname: Yoon
authors.affiliation: Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Ja Young
authors.initials: JY
authors.lastname: Jeon
authors.affiliation: Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Seung Jin
authors.initials: SJ
authors.lastname: Han
authors.affiliation: Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Dae Jung
authors.initials: DJ
authors.lastname: Kim
authors.affiliation: Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Kwan-Woo
authors.initials: KW
authors.lastname: Lee
authors.affiliation: Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Republic of Korea; Department of Biomedical Sciences, Ajou University Graduate School of Medicine, Suwon, Republic of Korea.
authors.forename: Rae Woong
authors.identifier: 0000-0003-4989-3287
authors.initials: RW
authors.lastname: Park
authors.affiliation: Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Hae Jin
authors.identifier: 0000-0002-8958-7164
authors.initials: HJ
authors.lastname: Kim
mesh_terms: D000368:Aged; D000418:Albumins / Q000032:analysis; D000419:Albuminuria / Q000188:drug therapy; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D003928:Diabetic Nephropathies / Q000517:prevention & control; D018819:Dipeptidyl Peptidase 4 / Q000378:metabolism*; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000627:therapeutic use*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D012189:Retrospective Studies
chemical_list: D000418:Albumins; D054873:Dipeptidyl-Peptidase IV Inhibitors; C042807:DPP4 protein, human; D018819:Dipeptidyl Peptidase 4